Purpura simplex

Introduction

Introduction to simple purpura Simple purpura is a common, unexplained vascular hemorrhagic disease. The clinical features are small skin defects and ecchymosis of different sizes, which are common in the lower limbs and arms. Repeated attacks, self-resolving, longer duration, more common in women. The pathogenesis of this disease may be related to capillary wall abnormalities and platelet dysfunction. Some patients may have abnormal ADP and adrenaline-induced platelet aggregation reactions, and a few may have platelet-to-glass adhesion rate and anti-platelet antibody positive. Some patients may also be caused by autosomal dominant inheritance, called familial simple purpura. The disease is non-destructive and generally requires no special treatment. Oral doses of vitamin C, vitamin P (trox rutin), carbachol, etc., can improve the permeability of the blood vessel wall, reduce symptoms and frequency of onset. basic knowledge The proportion of illness: 0.022% Susceptible people: more common in women Mode of infection: non-infectious Complications: acute nephritis, gastrointestinal bleeding, asthma

Cause

Simple purpura

Causes

The cause is unknown, and the onset may be related to the following factors:

1. May be a bleeding disorder caused by abnormal capillary wall.

2. More common in young women and children, prone to menstrual period, speculated whether it is related to increased estrogen and increased capillary permeability.

3. Platelet dysfunction may be one of its causes.

4. About one-third of patients have anti-platelet antibody-positive and may be associated with autoimmunity.

Pathogenesis:

May be associated with capillary wall abnormalities and platelet dysfunction.

Pathophysiology

The pathogenesis of this disease may be related to capillary wall abnormalities and platelet dysfunction. Some patients may have abnormal ADP and adrenaline-induced platelet aggregation reactions, and a few may have platelet-to-glass adhesion rate and anti-platelet antibody positive. Some patients may also be caused by autosomal dominant inheritance, called familial simple purpura.

Chinese medicine theory

The disease is mainly caused by bleeding symptoms, especially skin bleeding spots and bleeding spots, so it belongs to the range of "purple spots". In the medical journal "Nei Jing", he has a deeper understanding of the physiology and pathology of blood, such as Su Wen. "Paradox" said: "The battalion, the essence of the water valley is also, and transferred to the five internal organs, sprinkle Chen in the six hexagrams, but also the people in the veins, so the pulse up and down, through the internal organs." The "battalion" refers to "blood". "Ji Zong Jin Jian. In the Summary of Blood Loss, it states: "Blood bleeding and tendon spasm."

For the pathogenesis of this disease, "surgical authentic. The grape plague said: "Feeling the four-time unhealthy anger, the stagnation of the skin does not scatter, forming a large-sized bluish spot, the color of the grape...". Zhu Danxi believes that hair spots are mainly caused by heat, "Danxi hand mirror. Hair spots say: "hair spots, hot blaze." As for the location of the disease, "Jian Zong Jin Jian. Surgical method. In the grape plague, there is a clear understanding of the location of the disease: "It is all over the body, but the legs are mostly."

Prevention

Simple purpura prevention

The disease is more common in women, generally no significant harm to health, and a good prognosis. It belongs to the category of "blood bleeding syndrome" of Chinese medicine.

According to the pathogenesis of Chinese medicine in this disease, prevention should be taken to enhance physical fitness, daily living, and hastily overworked, should pay attention to rest after the onset.

Complication

Simple purpura complications Complications acute nephritis gastrointestinal bleeding asthma

Moderate lymphocytic infiltration and hemosiderin deposition in the upper part of the dermis, small blood vessels dilated.

Symptom

Simple purpura symptoms common symptoms skin purpura skin spots skin freckle

More common in women, the clinical features of small skin defects and ecchymosis of different sizes, common in the lower limbs and buttocks, repeated attacks, easy to attack and menstrual period, a few patients with beam arm test can be positive.

Most of the menstrual period of childhood and adolescent girls, most of the bleeding in the lower limbs, buttocks, or bleeding spots, do not bulge on the leather surface, the pressure does not fade. After a few days or weeks, the purpura subsides and leaves a cyan or yellow-brown pigmentation spot, which gradually disappears. Skin purpura can reappear and recur. Simple purpura is also occasionally seen in the upper limbs, but not in the trunk. Some patients have local skin pain when the skin purpura appears, generally not very intense. Some patients may also be caused by autosomal dominant inheritance, more common in women, with a positive family history, known as familial simple purpura.

Examine

Simple purpura examination

The beam arm test can be positive, the hemostatic function screening test is normal, the capillary fragility test is positive, some patients may have ADP, adrenaline-induced platelet aggregation abnormalities, and a few may have platelet-to-glass adhesion rate reduction, anti- Platelet antibody positive.

Diagnosis

Diagnosis and identification of simple purpura

1. Aspirin-like defects in the skin are unevenly distributed, mucosal bleeding is obvious, and hemorrhage in trauma surgery should be more important. The disease is an autosomal dominant genetic disease, platelet release dysfunction, patients are particularly sensitive to aspirin, platelet count and platelet reading ADP and other aggregation agents are normal, but platelet factor 3 (PF3) is not effective.

2. 1-3 weeks before the onset of allergic purpura, there is low fever, sore throat, general weakness or history of upper respiratory tract infection, skin purpura, confined to the limbs, especially the lower limbs and buttocks, the trunk is rarely involved. Aster is often repeated in a batch, symmetrically distributed, and can be accompanied by skin edema and urticaria. The size of the sable is different, and it is dark red at first. It can be fused to form a ecchymosis. It turns into purple, yellowish brown and light yellow within a few days, and gradually disappears after 7-14 days. May be associated with abdominal pain, joint swelling and pain and hematuria; platelet count, function and coagulation related tests are normal.

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