Are petechiae a rash?

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Skin without any feeling of discomfort or uneasiness is already considered a good skin by most people although certain people might want to have better skin by using skincare and meeting dermatologist or aesthetician. A reddish and bumpy skin might signify a skin disorder. Sometimes a skin disorder can signify other health problems apart from the skin itself. Hence, knowing the sign of a skin problem can help you to decide whether it needs medical care or not. In this DoctorOnCall article, we will know more about a sign of skin disorder called petechiae.

Petechiae might seem like a rash at first sight but truthfully is not. Petechiae actually is part of purpura. Purpura is defined as the discolouration of the skin or mucous membrane caused by haemorrhage or bleeding from small blood vessels known as capillaries. Petechiae is a small purpura with the diameter size up to 2 mm and has a flat surface. It is often described as pinpoint non-blanching spots because you would not see any changes of the petechiae colour if you press it to apply brief pressure. Petechiae colour initially starts with a red colour in accordance to the colour of bleeding. Over weeks, this blood usually breaks down and changes colour becoming purple, orange, brown, blue or green due to the oxidation process. The reasoning behind why a petechiae is not a rash is a rash is mediated by an inflammatory process triggered by the body immune and when you press against a rash, it will change to whitish colour.

Petechiae in most cases are caused by a harmless condition but in some cases, it could signify an underlying health issue that may require an urgent visit to the doctor. Most of the time it affects older adults and young children but that does not eliminate the probability of other age groups to have it. Petechiae often resolves on its own after a few days of its initial presentation. Although, in severe cases or caused by other diseases, this petechiae may spread all over the body and stay on for a long time.

Since petechiae can be caused by several health conditions that could progress into severe problems, it becomes a visible sign for healthcare practitioners to easily suspect a certain ailment when combined with other information gained from the patient through the patient’s medical history and physical examination. Laboratory test, imaging test and other supporting test will be requested by doctor to help ensure the suspected ailment is the right medical diagnosis. Petechiae in children might raise suspicion of meningitis (inflammation to the membrane covering brain and spinal cord) caused by infection of Neisseria meningitidis. Other pathogens inducing petechiae in children are influenza, cytomegalovirus (CMV), Epstein-Barr virus (EBV) and Streptococcus species. In old people, petechiae may be seen due to ageing skin or sun exposure caused by deficient support of the blood vessels. In the general population, petechiae can be a sign of an ongoing dengue disease and yellow fever. Blood disorders such as in leukaemia, intravascular coagulopathy (DIC) and immune thrombocytopenic purpura (ITP) can be presented with petechiae. Inflammation of blood vessels like vasculitis and chronic liver disease also is associated with petechiae. Heparin use may precipitate petechiae as a result of low thrombocyte cells functioning in the blood clot.

Treatments of petechiae are dependent on the vast medical conditions or underlying diseases. Even though most times petechiae is caused by certain health disorders, as mentioned, it can be a harmless condition and need not be a serious concern. This is especially true if it is caused by relentless coughing or prolonged straining during a bowel movement. It can also be due to injuries, sunburns and certain medicine side effects of antibiotics.

References:

https://www.ncbi.nlm.nih.gov/books/NBK482331/

https://dermnetnz.org/topics/purpura

 

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