For thepurpura fulminans, we speak of unpurpura of extreme severity, with 20 to 25% of mortality with, among the survivors, 5 to 20% of serious complications. This purpura is most often linked to meningococcus, but also to other infectious elements (chickenpox, streptococcus, staphylococcus, etc.). The management must be done urgently and the hospitalization necessary. From antibiotics will be given immediately, upon arrival of the SAMU or the attending physician, even before awaiting results. The people most at risk are children under 4 and young people between 15 and 24 years old.

In case of immunological thrombocytopenic purpura (ITP), the first objective of treatment is to raise the platelet count if it is below 30 / mm³. (normal rate between 150 and 000 / mm³). If it is at 30 / mm³ or more, even if the platelet count is abnormally low, it usually does not cause bleeding. On the other hand, if the platelet count is less than 30 / mm³, this is an emergency since the person is at risk of bleeding. Treatment with corticosteroids (derived from cortisone)may be prescribed but this treatment should be brief because it has significant side effects. Other treatments such as immunoglobulin injections may also be used.

In chronic immunologic thrombocytopenic purpura, the most effective treatment is to remove the spleen. Indeed, this organ manufactures the antibodies destroying the platelets and it also contains white blood cells, the macrophages destroying the platelets. Then, the ablation of the spleen (splenectomy), allows to cure 70% of chronic immunological thrombocytopenic purpura. You can live without a spleen, even if it puts you at a higher risk of infection.

If removing the spleen is not sufficient or insufficiently effective, other treatments exist, such as drugs that decrease the immune response, antibodies from biotherapies or drugs such as Danazol or Dapsone.

In the case of rheumatoid purpura, it is possible, again, that no treatment is offered, the purpura disappearing without sequel with time. Of repos is recommended, sometimes accompanied by antispasmodics to fight against abdominal pain.