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What Is the Difference between Petechiae and Purpura?

By Valerie Goldberg
Updated Mar 03, 2024
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Petechiae and purpura are similar, but purpura is the term used to describe any purple skin blotch caused by bleeding beneath the skin. Petechia is a sub-type of purpura that is normally caused by a physical trauma. Very small purple spots on the skin are normally petechiae, where as a purpura may be much larger.

A person should schedule a doctor's appointment if he or she believes petechiae and purpura are causing the strange markings on his or her skin. The doctor will need to run tests to see what is causing the blood vessel issues. It is possible for petechiae and purpura to occur together or separately.

Petechiae are often caused by injuries, accidents, excessive coughing or extreme bouts of vomiting. Certain medications and some types of allergic reactions also may cause petechiae. The doctor will likely ask a patient with signs of petechiae a list of relevant questions and run a complete blood count and platelet count.

Large purpuraj may be caused by vascular problems, platelet disorders, meningitis or a vitamin C deficiency. A medical professional may choose to do a skin biopsy on an area of the skin being affected by a purpura. Other tests that need to be done will depend on the patient's full list of symptoms.

The underlying cause of both petechiae and purpura will determine what treatments are needed. Patients who have developed the purple skin symptoms as the result of an injury may just have to wait for the spots to fade on their own. A person who tests positive for meningitis, however, will need immediate medical attention and a series of medications that may be lifesaving. Petechiae caused by an allergic reaction will typically clear up within a few days after the person stops being exposed to the allergen and is given allergy medication.

Some young children under age 7 may develop rheumatoid purpura, a form of purpura that does not typically affect adults. A majority of children's rheumatoid purpura symptoms will clear up on their own but, in some rare cases, other health problems also are present that may lead to renal failure if left untreated. Any child who develops spots that could be purpuraj should be evaluated by a pediatrician. Purpura in kids also can be caused by a syndrome called Purpura fulminans, a condition normally accompanied by vomiting and a high fever. A lumbar puncture can be done to make a diagnosis.

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Discussion Comments
By kylee07drg — On Nov 20, 2011

@orangey03 – For a child and especially for her parents, something as strange as purple spots under the skin can be frightening. When I saw a petechial rash on my daughter's neck, I grew very worried. She pointed it out to me with tears, and I called the doctor right away.

She had bronchitis at the time, so she had been coughing hard nonstop for three days. The doctor said that this was the cause of the rash.

Since she was already taking antibiotics to resolve the cause of the coughing, there was nothing to do but wait. If her rash had appeared and she hadn't been coughing so forcefully, she would have needed more tests.

The doctor seemed pretty certain of what it was, and he turned out to be right. The rash went away on its own in a week.

By orangey03 — On Nov 19, 2011

Purpura fulminans is a scary condition. My niece had it right after she got over the chicken pox.

She got several small bruises on her arms and legs. She also had chills, fever, and vomiting. Her parents were very worried, so they took her to the emergency room.

The doctor gave her a lumbar puncture, and he found that it was purpura fulminans. He gave her antibiotics and a blood thinner, and she made a full recovery.

What was so scary was that he said the condition could be fatal within three days if not treated. I am so glad that her parents saw fit to take her to the hospital right away.

By shell4life — On Nov 18, 2011

I had petechiae and purpura on my leg after I punctured it with the edge of the car door. I ran into it without realizing it was open, and it hurt so much!

I saw a scattering of purple spots under my skin. They resembled clusters of stars, and some of them reached out and resembled spiders.

I wasn't worried, because I knew what had caused them. It took about a month for them to go away, which is much longer than most bruises last. I guess the damage was deeper than with a regular bruise.

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