What is Petechial rash?
Petechial rash is referred to as the small, flat red or purple spots on the skin or in the mucus membrane. They often appear because of the presence of broken blood vessels under the skin. Sometimes, petechiae look similar to a rash.
Usually, petechiae occur because of physical trauma, for instance, excessive crying, prolonged vomiting and violent coughing. These types can lead to facial petechiae, mostly in the periorbital region or around the eyes. Sometimes, petechiae manifest in aging skin. These types are rarely harmful and they usually subside after a few days.
However, petechiae may also signal a deadly blood disease such as thrombocytopenia. In this type of blood disorder, the platelet level of the blood is significantly low which results to poor clotting mechanism. Additionally, petechiae can also denote another life-threatening blood disorder known as idiopathic thrombocytopenic purpura. This is also a platelet related disease. It is actually similar to thrombocytopenia but its etiology is unknown.
Certain medications may also be the reason why such impairment in the ability to form blood clots and the succeeding petechiae occur. Some of the medications which have this ability are the steroids, anticoagulants, aspirin and antiplatelet medications.
Petechial Rash Symptoms
Petechiae can manifest with other symptoms, this can differ according to its condition, disorder or underlying disease
Petechiae can manifest with other symptoms such as:
- Hematoma or otherwise referred to as the extravasation of clotted blood under the skin
- Inexplicable nose bleeding
- Profuse vaginal bleeding during menstruation (menorrhagia)
- Disproportionate bleeding from the gums
- Bruising or easy bleeding
In rare cases, petechiae may signify a fatal condition that should warrant immediate evaluation in an emergency setting.
- Momentary loss of consciousness or confusion
- Elevated temperature or high grade fever
- Severe headache
- Profuse bleeding
Petechial Rash Causes
Usually, petechiae results when the blood vessels or capillaries under the skin break. Generally, petechiae occurs form physical trauma. It is not uncommon to find petechiae in aging skin. However, petechiae may also denote life-threatening blood diseases wherein the blood has an impairment in its clotting mechanism. This then results in petechiae. Additionally, some medications also can be the root cause of petechiae. It can also arise from injury or trauma.
Traumatic causes of petechiae
Petechiae may also result from physical trauma such as:
- Excessive vomiting
- Extreme crying
- Violent coughing
- Trauma or injury
Petechiae from drug related cause
Petechiae may also be attributed to the patient’s reactions to certain medications, such as:
- Carbamazepine (Tegretol,Carbatrol)
- Cimetidine (Tagamet)
- Chlorothiazide (Diuril, Chlotride)
- Phenytoin (Dilantin, Di-Phen)
- Acetaminophen (Tylenol)
- Heparins such as low molecular weight heparin
- Naproxen (Aleve, Naprosyn)
- linezolid (Zyvox)
- Rifampin (Rimactane, Rifadin)
Grave or critical causes of petechiae
In rare cases, petechiae could denote the presence of a grave or critical condition that should warrant immediate evaluation in an emergency setting, such as
- Defect in blood clotting factor
- Thrombocytopenia which arises from low blood platelet count (platelets aid in forming blood clots to halt blood loss)
- Idiopathic thrombocytopenic purpura, which is thrombocytopenia but with unknown etiology
- DIC or Disseminated intravascular coagulation which is a syndrome that usually arise in depletion of blood clotting factors)
- Grave infections such as meningococcal infection or enterovirus infection
- Autoimmune disorders, which are conditions in which the person’s body creates antibodies that fights its own tissues for unidentified reasons
- Liver disorders, such as liver cirrhosis
- Bone marrow disorders, such as leukaemia
- Infections, such as infectious mononucleosis (glandular fever)
Other causes would include:
- Blood infection or sepsis
- Previous Blood transfusions
- Nutritional deficiencies, for instance, deficiency in folic acid or vitamins or B12, C, or K
- Vaginal birth, arising from the pressure changes caused by vaginal delivery
- Medical treatment, for instance chemotherapy and radiation therapy for cancer
Petechial Rash Treatment
In order to treat the presence of petechiae, the underlying cause must first be determined. For those who are suffering form petechiae from infection, antibiotics must be given. If the root cause of the petechiae is because of low platelet count, the patient may be required to undergo blood transfusion such as platelet transfusion or other blood factors. If the reason why the patient is having petechiae is because of an allergy to a certain medication, then the medication being given should be stopped at once. If the patient having the petechiae has cancer or leukemia, that patient must undergo radiation therapy, chemotherapy or surgery if needed. If the petechiae arise from injury, then no treatment will be required. An ice pack can be placed intermittently over the injured area for a span of 24 hours in order to halt the progress of the petechial rash. The petechiae will subside over a certain period of time.
Petechial Rash in Children
Petechiae are tiny red or purple dots that usually appear on the body and in the mucus membrane. In order to correctly diagnose a petechial rash, you can seek the help of a dermatologist. The dermatologists are the most skilled specialists in identifying and treating petechial rash. They can easily differentiate the difference between a petechial rash, purpuric rash and vasculitis. These conditions should be given immediate treatment so as not to worsen its present state. The severity of petechial rash in infants and children vary on the clinical context. Those children who are suffering from viral infections are more prone to having petechial rashes. However, it does not automatically denote the presence of a life-threatening condition. Alternatively, there are certain types of conditions such as leukemia, meningococcemia and thrombocytopenia which also causes petechial rash but should be given prompt attention and should not be disregarded.
If a child presents with a petechial rash, he or she should be considered as ‘unwell’ if any of the following are noticed:
- The child has abnormal vital signs, such as when patient is having hypotension or abnormal pulse pressure, tachycardia, SpO2 desaturation or tachypnea
- The child is either irritable or lethargic
- The child has inadequate peripheral circulation which can be manifested with cool peripheries,
- It’s probably reasonable to add: if the doctor, nurse or the parents think the child is unwell regardless of those mentioned.
If a child with petechial rash, who is considered as a ‘well’ child but the following signs are noticed, he or she should also be treated as ‘unwell’.
- Abnormal laboratory parameters
- The petechiae advance in extent during the 4 hours observation period
- Purpura (lesions >2 mm) develop
If the above mentioned signs are present, it should be treated as a potentially life-threatening emergency. The child must be immediately brought to an area that is equipped for resuscitation at once.
Petechial Rash Pictures
source : selfcarenavigator .com
source : webmm .ahrq .gov
source : baby-medical-questions-and-answers .com
source : aafp .org