Petechiae

punctiform, the result of the leakage of blood from small blood vessels.

Petechiae: characteristics

• Dimensions: by definition, they do not exceed 3 mm
• Shape: smooth surface, irregular shape, often rounded
• Chroma: varies from bright red to blue-purple. In the final stage, the petechiae are greenish and yellowish
• Localization: petechiae are typical of the lower or upper limbs. They can also appear on the face, abdomen, kidney, retina and mucous membranes.
• Symptoms: none. Petechiae are not painful.

Petechiae: causes

• Petechiae dependent on impaired blood clotting capacity: amyloidosis, rheumatoid arthritis, haemophilia, leukemia, lupus erythematosus, mononucleosis, measles, thrombocytopenia, anticoagulant therapy
• Petechiae dependent on other pathologies: vitamin K deficiency, dengue, bacterial endocarditis, scurvy, Cushing's syndrome, trauma, vomiting and cough.

Petechiae: therapies
Treatment for petechiae depends on the triggering cause.

or in a fabric, giving rise to the typical red spot that distinguishes petechiae. Together with purpura and ecchymosis, petechiae identify bleeding - mostly superficial - in the skin or mucous membranes.
Although they are a mild form of superficial bleeding with no external blood loss, petechiae can be associated with more severe bleeding.
It is rare to observe only one or two petechiae on the skin: more often, in fact, small point hemorrhages are grouped, so much so as to develop a real skin rash. Petechiae can overlap or grow side by side: by doing so, they can easily be mistaken for purpura or bruising.
But let's see the general characteristics of petechiae, the triggering causes and possible treatments.

hyperpigmented and punctate that grow on the skin and mucous membranes, generally due to the lack of blood coagulation elements. These cutaneous micro-macules are as big as the head of a pin; they have a smooth surface and an irregular shape, usually rounded.
Since these are effusions of blood in a tissue following a rupture of small vessels, petechiae also have the typical chromatic variation that characterizes all types of hematomas. At first, the petechiae take on a bright red color; subsequently, they are dressed in a bluish or purple color, and then gradually fade to golden green-yellow. In most cases, petechial lesions resolve themselves within a few days.
Petechiae are not cleared by acupressure.

LOCATION

Petechiae are typical micro-lesions of the skin. The petechial rush tends to occur in particular in the lower limbs, especially in the feet and ankles. However, it is not uncommon to find petechiae on the abdomen or in other areas of the body.
Ideally, petechiae can develop in any anatomical location: they are not, therefore, an exclusive lesion of the skin as might be assumed. Petechial lesions can therefore form in any tissue supplied by the systemic circulation: for example, among the various signs associated with bacterial endocarditis, petechiae also stand out. The concomitant presence of petechial lesions in the retina, skin, mucous membranes (especially the mucosa sublingual) and kidney must alarm: in this case, it is conceivable that the cause of petechiae lies precisely in bacterial endocarditis. In similar situations, in the kidney, petechiae tend to develop in the cortical region, giving rise to a pattern known as "flea bites".

SYMPTOMS

Petechiae develop completely asymptomatically: in fact, these small bruises on the skin are not associated with any pain or discomfort. More than symptoms, petechiae are associated with "signs", that is to say purely aesthetic manifestations.

. But why do the small ducts of the circulatory system break?
The rupture of a capillary, with the subsequent pouring of blood into the underlying tissue, can result in alterations in the coagulation capacity of the blood, or in various pathologies or disorders.

1. Petechiae dependent on coagulation disorders can be caused by:
   • Amyloidosis: disease characterized by the abnormal deposition of low molecular weight proteins in the extracellular area. The appearance of red spots on the skin (purpura, petechiae, ecchymosis) is a characteristic symptom of amyloidosis.
   • Rheumatoid arthritis
   • Hemophilia: pathology characterized by a marked tendency to bleeding. The defect in blood clotting predisposes the patient to petechiae.
   • Leukemia: petechiae are the result of the reduction in the number of circulating platelets, a distinctive element of leukemia.
   • Systemic lupus erythematosus
   • Mononucleosis, measles and rubella: Similar infections predispose the patient to the formation of small red spots on the skin.
   • Platelets: blood disorder characterized by a more or less significant reduction in blood platelets (<150,000 units per mm3 of blood)
   • Idiopathic thrombocytopenic purpura: This is an autoimmune disease that is distinguished by the destruction of thrombocytes by auto-antibodies. Among the most frequent consequences, the appearance of red spots on the skin stands out (e.g. petechiae, purpura, etc.)
   • Long-term therapy with oral chemotherapy or antidiabetic drugs
2. Petechiae are sometimes associated with other diseases, such as:
   • Vitamin K deficiency: fortunately rare disease, which manifests itself with a more or less evident hemorrhagic syndrome (petechiae, ecchymosis, etc.), expression of the inadequate synthesis of coagulation factors.
   • Dengue (acute viral disease triggered by Flavivirus infections, the same pathogens involved in the manifestation of yellow fever). Some patients with mild dengue suffer from bleeding manifestations, such as epistaxis, gingival bleeding, and subcutaneous punctate hemorrhages (petechiae). In severe cases, petechiae can turn into real hematomas.
   • Bacterial endocarditis (analyzed in the previous paragraph)
   • Infantile scurvy: it is a disease of severe vitamin C deficiency. In the context of scurvy, the walls of the blood capillaries are fragile and weakened, therefore the affected patient manifests petechiae and bruising throughout the body.
   • Cushing's syndrome: petechiae and ecchymosis also stand out among the most recurrent clinical manifestations associated with Cusching's syndrome. The loss of subcutaneous tissue predisposes the affected patient to rupture of the vessels, therefore to the formation of micro-hematomas.
   • Trauma: petechiae can also result from minor trauma inflicted on the skin.
   • Vomiting and coughing: gagging and violent coughing can weaken the walls of the capillaries, until they break. In such situations, petechiae form on the face, especially around the eyes.

Skin aging also exposes the subject to the risk of blood vessel rupture: as the age progresses, the blood vessel wall becomes more fragile, therefore more prone to bruising, petechiae and bruising.

C. Even the administration of Vitamin E seems to be beneficial for the disappearance of petechiae: tocopherol inhibits the increase in permeability of the capillary walls, induced by drugs or by bacterial / viral infections.
Petechiae dependent on thrombocytopenia can sometimes be treated with steroid drugs - useful for reducing bleeding - or by administering immunoglobulins (in the case of thrombocytopenia dependent on abnormal immune responses).
Chemotherapy therapy is indicated for the treatment of leukemia: even this tumor form can in fact favor the formation of petechiae. The treatment of leukemia favors the restoration of the composition of the blood, as a result, the petechiae disappear.
For further information: read the article on drugs for the treatment of petechiae.