Purpura is the name given to spots that appear on the skin or mucous membranes (such as inside the mouth), showing a colour change from red to purple, caused by small bleeds from blood vessels. These spots usually don't fade when pressed with a finger, because blood cells that have left the blood vessels have collected within the skin. When these bleeds are small, pinpoint-sized, they're called “petechiae”; when larger than 1cm, they're called ‘ecchymoses’.
Purpura can occur for different reasons:
A low platelet count (thrombocytopenia),
Clotting disorders (such as haemophilia-like conditions),
Blood vessel inflammation (vasculitis),
Reactions to medications or infections,
Other blood-related conditions (such as certain forms of leukaemia).
Damage to small blood vessels can also occur for reasons unrelated to clotting factors or platelets. For example, we can see purpura developing in sun-damaged, aged skin due to trauma or insufficient vessel support (senile purpura).
Although purpura can generally be seen anywhere on the body, it often becomes noticeable on the legs, arms and sometimes the mucous membranes. If additional findings such as fever, fatigue or joint pain are present alongside purpura, further investigation is needed. Treatment varies depending on the underlying cause. If the purpura is medication-related, stopping the medication; if related to a blood condition, haematological support and, if necessary, immune-regulating treatments can be applied. For this reason, it's important to consult a doctor and undergo the necessary investigations whenever purpura is identified.