palpable purpura

Introduction

Palpable lesions with purpura. (Also see purpura)

Etiology

• small-vessel vasculitis
  • leukocytoclastic vasculitis* - Henoch-Schonlein purpura
  • eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
  • polyarteritis nodosa
  • systemic lupus erythematosus
  • mixed cryoglobulinemia
• emboli
  • acute meningiococcemia
  • disseminated gonococcal infection
  • rickettsial
    • Rocky Mountain spotted fever
    • epidemic typhus
  • ecthyma gangrenosum
• infectious (also see emboli)
  • hepatitis, hepatitis C
  • atypical measles
  • echovirus 9
  • TORCH group
  • Staphylococcus
  • Pseudomonas sepsis
  • bacterial endocarditis
  • HIV

* a hypersensitivity vasculitis

Laboratory

• skin biopsy

Complications

• small vessel vasculitis may affect internal organs

Differential diagnosis

• erythema nodosum (tender or painful)
• see small-vessel vasculitis for differential diagnosis

Management

• cutaneous small vessel vasculitis (palpable purpura) can be managed with
  • rest & elevation of affected region
  • topical glucocorticoids
  • NSAIDs
  • antihistamines

More general terms

• sign/symptom
• purpura; retiform purpura

Additional terms

• erythema nodosum (septal panniculitis)