- The blood vessels are inflamed and occluded by a variety of conditions.
- For a work up of palpable purpura, see small vessel vasculitis and here.
Distal Extremity Petechial Rash
Meningococcemia: The classic patient is a child or teenager who acutely develops an intense headache, nausea, vomiting and fever. Meningeal symptoms may occur and the mental state may deteriorate to disorientation or even coma. Hypotensive shock and death may rapidly ensue..
Rocky mountain spotted fever: Prodrome of fever and headache followed by 3-4 days later by a maculopapular rash which begins on the wrists and ankles and spreads to the rest of the body including the palms and soles.
Typhus and other ricketsial disease, see for example, [Am J Trop Med Hyg. 2010;82;691].
Child with Purpura
Acute Hemorrhagic Edema of Infancy
Purpura Fulminans, e.g. after chickenpox or from sepsis. Or neonatal PF secondary to hereditary deficiencies of clotting factors. e.g. Indian J Anaesth. 2012 May-Jun; 56(3): 283–286.
Scurvy, e.g. Pediatr Rheumatol Online J. 2015; 13: 23.
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