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Emergency
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Apollo Lifeline
Verified By Dr AISHWARYA MALLADI October 10, 2023
Petechiae is a condition in which red spots of 1-2 mm appear on any part of the body. It occurs due to intradermal (between epidermis and hypodermis) capillary bleeding. These spots are non-blanching as they do not disappear on applying pressure. Both petechiae and purpura are non-blanching spots. Purpura is bigger than the petechiae and develops due to bleeding within the skin, and its size is more than 2 mm.
The blood clot is a series of controlled events that require endothelium (exposed), tissue factor, collagen, platelets, platelets activating factors (PAF), prothrombin, fibrinogen, von Willebrand factors (vWF), and other cofactors to work. Platelets are closely associated with regulating pro-angiogenic factors, such as vascular endothelial growth factor (VEGF), angiopoietin 1, etc. Petechiae, a hemorrhagic lesion that involves excessive bleeding, is a common phenomenon associated with thrombocytopenia. A noticeable decrease in the platelet count (10,000-20,000/cubic millimeter) occurs during thrombocytopenia. It disrupts the whole assembly, the endothelial barrier becomes leaky, and erythrocytes (blood cells) enter the surrounding tissues. This event and disruption of several other physiological events manifest into petechiae (superficial lesions) and purpura (deep lesions).
The appearance of petechiae may look like a rash, but it isn’t one. They are pinpoint red dots on the skin developed due to broken blood vessels under the skin. Petechiae is not itchy or painful. When you press on petechiae, it remains purple, red, or brown, whereas a rash turns pale or lighter when applied pressure.
As mentioned above, petechiae appear as flat, pinpoint-sized red, brown, or purple dots. Several petechiae in one place may look like a rash. However, when applying pressure on rashes, they turn pale, but the colour of the petechiae remains the same. If you notice larger, red, or purple spots, it is one of the types of bleeding problems known as purpura.
You may develop petechiae anywhere in the body, sometimes noticed inside the mouth or eyelids.
When the blood vessels break open, the blood leaks into the skin, forming petechiae. The two most common causes are infections and reactions to medications. The other causes include the following:
| Possible Cause | Additional symptoms and information |
| Cytomegalovirus (CMV) | It is a viral illness with symptoms of fatigue, fever, sore throat, and muscle pain. |
| Endocarditis | When the heart’s inner lining gets infected, the patient develops symptoms such as fever, chills, fatigue, joint and muscle pains, breathing difficulties, and pale skin. |
| Hantavirus Pulmonary Syndrome | A viral infection shows symptoms similar to the flu. The symptoms of hantavirus pulmonary syndrome include breathing difficulties, fatigue, fever, and muscle pain. |
| Injuries | Any damage to the skin, such as biting, hitting, or a car accident, may cause petechiae. It can also form due to friction against the skin due to carrying a heavy bag or a tight strap of clothing and a sunburn. |
| Leukaemia | Bone marrow cancer is known as leukaemia. The symptoms of leukaemia include fever, chills, fatigue, unintentional weight loss, swollen glands, bruising, nosebleeds, and night sweats. |
| Meningococcemia | A respiratory tract bacterial infection may show signs of fever, headache, muscle pain, and nausea. |
| Mononucleosis (Mono) | Mononucleosis, commonly known as mono, is a viral infection. It is transmitted through saliva and other bodily fluids. The symptoms include fatigue, sore throat, fever, lymph node and tonsils swelling, and headaches. |
| Rocky Mountain Spotted Fever | Ticks transmit the rocky mountain spotted fever. The symptoms include high fever, chills, extreme headache, muscle aches, nausea, and vomiting. |
| Scarlet Fever | If you have recently recovered from strep throat, you are at high risk of developing a bacterial infection known as scarlet fever. Its symptoms include a rash, red scars on the skin, flushed face, red tongue, fever, and sore throat. |
| Scurvy | Lack of vitamin-C causes scurvy. Watch for signs such as fatigue, swollen gums, joint pain, breathing difficulties, and bruising. |
| Sepsis | The symptoms of this life-threatening blood infection are high fever, increased heart rate, and breathing difficulties. |
| Straining | When you strain yourself, you cause the blood vessels in the skin to break in the face, neck, and chest. Activities such as crying, giving birth, coughing, lifting weights, or vomiting should be completed without straining too much. |
| Strep throat | It is a bacterial infection that causes a sore throat. Watch for symptoms such as fever, nausea, headache, vomiting, body aches, and swelling in the tonsils and glands. |
| Thrombocytopenia | It is a medical condition where you have few platelets that help in a blood clot. If you experience bruising, bleeding from your gums and nose, blood in urine or stool, fatigue, and yellow skin and eyes, meet your doctor at the earliest. |
| Vasculitis | You may suffer from vasculitis when the blood vessels swell, narrow, and scar. The symptoms include fever, headache, fatigue, weight loss, aches and pains, night sweats, and nerve problems. |
| Viral hemorrhagic fever | Dengue, ebola, and yellow fever are categorized as viral hemorrhagic fever. These infections make it difficult for your blood to clot. It would be best if you looked for symptoms such as high fever, fatigue, light-headedness, weakness, pains, and bleeding under the skin. |
There are specific medications that cause side effects resulting in petechiae. The following are medications and their side effects:
| Medication | Example |
| Antibiotics | Penicilin, nitrofurantoin |
| Antidepressants | Desipramine |
| Antiseizure drugs | Carbamazepine |
| Blood thinners | Heparin, warfarin |
| Heart rhythm drugs | Atropine |
| Nonsteroidal anti-inflammatory drugs | Indomethacin and naproxen |
| Sedative | Chloral hydrate |
If you or your child develops petechia, seek medical advice immediately. It can mean an underlying medical condition that could be severe or mild. The severity of the condition can only be known after a medical diagnosis. You should immediately meet a doctor if you experience the following symptoms:
It is best to visit doctors when you start observing the initial signs and symptoms of petechiae. This will protect your vitals, such as the heart, brain, kidneys, and gut, etc., from being affected.
There is no specific remedy or treatment method for petechiae. Petechiae appears due to a disease condition. So, depending on the particular clinical condition, medicines will be prescribed by doctors.
Some treatment methods or remedies for clinical conditions are:
| Disease or deficiency | Treatment/Remedy |
| Vitamin K deficiency | Vitamin K enriched food should be consumed. If a mother is suffering from VKDB, vitamin K shots should be given to the infant. |
| Immune thrombocytopenic purpura (ITP) | The treatment for adults will be as prescribed by doctors. |
| Henoch-Schonlein purpura | Doctor may prescribe or suggest non-steroidal anti-inflammatory drugs (NSAIDs) or antibioticsDialysisKeep yourself protected from allergies. |
Petechia does not cause any complications. However, it could be a symptom of underlying medical conditions that may cause complications, such as
If your child has a fever with petechiae, it can be a sign of a serious infection such as meningococcal disease. Seek immediate medical attention.
The doctor will assess the child for rashes and discuss their symptoms and recently recovered condition. Blood and urine tests may be conducted to determine the petechiae’s cause. Other diseases may also cause this condition. Keep an eye out for the following symptoms:
Call your doctor immediately for any other concerns and questions.
If you are suffering from an underlying medical condition with petechiae, the petechiae may persist and spread to other parts of the body until the medical condition is not treated. It also depends on the severity of the condition. But if the petechiae develop without any medical condition, it resolves on its own within a few days.
When bacterial or viral infection causes petechiae, the skin spots should disappear as soon as the infection is treated. If it is the side effects of the medication, the symptoms should stop once the medication is discontinued. Also, it is important to constantly monitor the spots for change or the number of spots increase, which can indicate a bleeding disorder.
Doctors recommend a treatment plan after thoroughly assessing the cause and other symptoms. The doctor may prescribe the following medications:
You can also complete the following at home:
If you develop petechiae, immediately seek medical attention. However, you can try the following home remedies that can help:
Preventing medical conditions is one way to avoid petechiae. However, not all medical diseases are preventable. You need to avoid medication that causes side effects and let your doctor know about it. The other ways to prevent infection that causes petechiae are as follows:
Petechiae is an indication (or alarm) for the early (majorly), middle, or late phase (majorly) of a disease. Hence, these small red spots should be taken seriously, as it marks the beginning of a critical condition (if you are not suffering from chronic diseases). So, a person should identify petechiae to prevent severe health ailments.
Petechia may be caused due to various infectious and non-infectious medical reasons. It can be due to bacterial, fungal, or viral infections, including the following:
. It can be due to bacterial, fungal, or viral infections, including the following:
The following medications cause petechiae:
Typically, petechia is a symptom of a medical condition. The medical condition may be mild to life-threatening.
Both are caused due to blood vessels breaking under the skin. Petechiae are pinpoint spots that are red, purple, or brown, whereas purpura is formed in larger areas that can be purple.
If your child has petechiae, it can signify a severe illness or medical urgency. Seek immediate medical attention if you notice the following:
MBBS, MD (Dermatology), Venereology & Leprology, Consultant Dermatologist, Apollo Hospitals, Health City, Visakhapatnam
October 25, 2024
