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Petechiae is a large number of small punctate blood extravasations visible on the skin or mucous membranes, occurring as a result of damage to the walls of capillaries or small arterioles. Ecchymosis is distinguished from normal or spider-shaped dilatation of these vessels by the fact that they do not disappear under the action of temporary pressure.
What are petechiae?
Petechiae are small skin lesions, extravasations of blood from capillaries on the skin or mucosa. They appear as a result of high pressure in the capillaries and the penetration of erythrocytes through the vessel walls. When the vessel wall is damaged, the coagulation system stops functioning. The average petechiae is about 1-3 millimeters, although the red spots may cover a larger area. Petechiae can be located all over the body, but the most common areas are the legs, abdomen, arms, face, and chest. Unlike rashes, petechiae do not turn pale under pressure and are usually red, dark red or purple in color. Petechiae are also called petotia. The occurrence of petechiae on the skin may indicate the existence of a disease in the body, so in any case you should visit a doctor who will make an appropriate diagnosis and find the cause of skin changes.
The causes of petechiae
The presence of ecchymosis is an indicator of the above-mentioned damage to the vessel walls (vascular diathesis) due to increased pressure in them and thus penetration through the walls of erythrocytes. The damage may take place, for example, during vomiting, strong crying or coughing. Then blue-red spots appear around the eyes. These are harmless changes that disappear after a few days. In addition, petechiae may be the consequence of:
- mechanical injuries – most often bruises, i.e. larger ecchymoses, form on the skin as a result of injuries. However, minor injuries, e.g. abrasions or prolonged pressure, may contribute to the formation of bloody ecchymoses, especially when the condition of the vessels is very poor;
- a small amount of clotting factors (clotting problems);
- the use of anti-aggregating drugs that lead to the inactivation of platelet function (this is a deliberate action, although an overdose of the preparation is manifested by the appearance of ecchymosis);
- thrombocytopenia
- infectious diseases, e.g. scarlet fever, mononucleosis, or hemorrhagic fever;
- vasculitis;
- spotted typhus;
- leukemia;
- vitamin deficiencies (especially vitamin C);
- cytomegalovirus infection;
- cat scratch diseases;
- influenza A virus subtype H1N1;
- celiac disease;
- infective endocarditis;
- Schönlein-Henoch disease, i.e. acute inflammation of small blood vessels (petechiae are mainly located on the buttocks and ankles);
- systemic lupus erythematosus;
- Kawasaki disease.
Petechiae and diagnostics
Each skin lesion, especially ecchymosis, should be consulted with a doctor and well diagnosed. It is important to determine whether the petechiae are accompanied by any other symptoms or occur on their own. By themselves, haemorrhages do not cause any noticeable harm to the body. During diagnosis, it is important to differentiate petechiae from vasculitis and other vascular diseases with similar symptoms. In addition, it is necessary to exclude rash and other dermatological ailments. To do this, go to a dermatologist who has the most knowledge and experience in this type of ailments.
Basic diagnostics of petechiae on the skin and mucous membranes includes:
- medical interview,
- blood count (with the measurement of platelets and blood clotting time).
It happens that during the medical interview it turns out that the ecchymosis occurred after intense physical exertion. Then they should disappear spontaneously after a few days. However, if petotia is one of the symptoms, and in addition to them, the patient develops high temperature and abdominal pain, or general malaise – diagnostics should be extended. When infective endocarditis is suspected, an echo of the heart and an ECG test are additionally performed, while in the case of, for example, scarlet fever, blood cultures are performed to detect possible bacteria in the body.
Treatment of petechiae
If the cause of ecchymosis is associated with increased pressure in the capillaries, as a result of vomiting, coughing or childbirth – there is no need to take specific measures, because the skin changes will disappear spontaneously after a few days. However, when we are not sure as to the cause of the ailments, and the skin changes intensify and do not disappear, see a doctor. Treatment is mainly prevention, i.e. the use of an appropriate diet and vitamin C supplementation, which strengthens blood vessels and is responsible for their proper structure. If ecchymoses appear as a result of taking anticoagulants, the dose should be reduced or (if possible) the drug should be discontinued completely.