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a minute red or purple spot on the surface of the skin as the result of tiny hemorrhages of blood vessels in the skin (as in typhoid fever)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/02/03 01:19:02」(JST)

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A petechia (pron.: /pɨˈtiːkiə/; plural petechiae /pɨˈtiːkɪ.iː/) is a small (1-2mm) red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels).^[1]

"Petechiae" refers to one of the three major classes of purpuric skin conditions. Purpuric eruptions are classified by size into three broad categories. Petechiae is generally used to refer to the smallest of the three classes of purpuric skin eruptions, those that measure less than 3 mm.

Causes

The most common cause of petechiae is through physical trauma such as a hard bout of coughing, vomiting or crying, which can result in facial petechiae, especially around the eyes. Petechiae in this instance are harmless and usually disappear within a few days. Petechiae may be a sign of thrombocytopenia (low platelet counts) when platelet function is inhibited (e.g., as a side effect of medications or during certain infections), or in clotting factor deficiencies.^[1] They may also occur when excessive pressure is applied to tissue (e.g., when a tourniquet is applied to an extremity or with excessive coughing or vomiting).

If unsure, petechiae should always be quickly investigated. They can be interpreted as vasculitis, an inflammation of the blood vessels, which requires immediate treatment to prevent permanent damage. Some malignancies can also cause petechiae to appear. Petechiae should be investigated by a doctor to rule out the more dangerous conditions. Dermatologists can be the most helpful specialists in these conditions because they can more easily identify if the condition is petechiae or some similar looking but less worrisome rash.

The significance of petechiae in children depends on the clinical context in which they arise. Petechiae in children can occur with viral infections. In this instance, they do not necessarily signify a serious illness. However, they are a hallmark signal of some potentially serious illnesses, such as meningococcemia, leukemia, and certain causes of thrombocytopenia, of which meningococcemia can cause death within 48 hours of infection. Therefore, their presence should not be ignored.

Petechiae (in the face) may also be present in cases of self asphyxiation.

List of associated conditions

Infections

Bolivian hemorrhagic fever
Boutonneuse fever
Cerebral malaria
Congenital cytomegalovirus
Congenital syphilis
Crimean-Congo hemorrhagic fever
Dengue fever
Duke's disease
Ebola
Endocarditis
H1N1
Hanta virus
Infectious mononucleosis
Marburg virus
Neisseria meningitidis
Rocky mountain spotted fever
Scarlet fever
Typhus ^[2]

Non-infectious conditions

Hypocalcemia
Idiopathic thrombocytopenic purpura
Leukemia
Celiac Disease
Aplastic anaemia
Scurvy
Lupus
Childhood protein-energy malnutrition such as Kwashiorkor or Marasmus
Erythroblastosis fetalis
Henoch-Schönlein purpura
Kawasaki disease
Schamberg's disease
Ehlers–Danlos syndrome

Non-diseases

Gua Sha, a Chinese treatment that scrapes the skin
High-G training
Hickey (injury)
Asphyxiation (discussed below)

Causes of particular types

Palatal petechiae.

Petechiae on the soft palate are mainly associated with streptococcal pharyngitis,^[3] and as such it is an uncommon but highly specific finding.^[4] 10 to 30 percent of palatal petechiae cases are estimated to be caused by suction such as can be habitual or secondary to fellatio.^[5]

Facial petechiae, especially around the eyes, indicate physical trauma such as by hard bouts of coughing, vomiting or crying.

References

^ ^a ^b Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. p. 86 ISBN 978-1-4160-2973-1
^ Grayson MD, Charlotte (2006-09-26). "Typhus". MedlinePlus Medical Encyclopedia. National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/001363.htm. Retrieved 2007-11-05.
^ Fact Sheet: Tonsillitis from American Academy of Otolaryngology. "Updated 1/11". Retrieved November 2011
^ Brook I, Dohar JE (December 2006). "Management of group A beta-hemolytic streptococcal pharyngotonsillitis in children". J Fam Pract 55 (12): S1–11; quiz S12. PMID 17137534.
^ Page 134 in: Michael Glick; Greenberg, Martin Harry; Burket, Lester W. (2003). Burket's oral medicine: diagnosis & treatment. Hamilton, Ont: BC Decker. ISBN 1-55009-186-7.

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UpToDate Contents

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1. 血小板減少症を有する成人患者に対するアプローチ approach to the adult patient with thrombocytopenia
2. 血管炎の皮膚病変を有する成人の評価 evaluation of adults with cutaneous lesions of vasculitis
3. 小児における紫斑の評価 evaluation of purpura in children
4. 成人の特発性皮膚小血管性血管炎患者の管理 management of adults with idiopathic cutaneous small vessel vasculitis
5. 出血性素因を有する成人患者へのアプローチ approach to the adult patient with a bleeding diathesis

English Journal

Accessory spleens at autopsy.

Unver Dogan N, Uysal II, Demirci S, Dogan KH, Kolcu G.SourceDepartment of Anatomy, Selcuklu Medical School, Selcuk University, Konya, Turkey. nunver2003@yahoo.com.
Clinical anatomy (New York, N.Y.).Clin Anat.2011 Sep;24(6):757-62. doi: 10.1002/ca.21146. Epub 2011 Mar 3.
Accessory spleens (AS) may be formed during embryonic development when some of the cells from the developing spleen are deposited along the path from the midline, where the spleen forms, over to its final location on the left side of the abdomen. An accessory spleen is usually near the spleen's hilu
PMID 21374729

Postendoscopic retrograde cholangiopancreatography pancreatitis: a rare cause of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.

Jeliazkova P, Noe S, Jost P, Sarkar O, Kuchle C, Schmid RM, Geisler F.SourceaII. Medizinische Klinik bIII. Medizinische Klinik, Klinikum rechts der Isar, Technische Universitat Munchen, Germany.
European journal of gastroenterology & hepatology.Eur J Gastroenterol Hepatol.2011 Sep;23(9):825-7.
Endothelial injury is perhaps the inciting factor leading to the microangiopathic process that initiates thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS). TTP-HUS after postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is extremely rare, but potentially is
PMID 21716116

Japanese Journal

法医学講義ビニール袋を被り窒息死した2事例

永江圭吾,塚正彦,大島徹
日本警察医会雑誌 6(2), 14-19, 2011-03
NAID 40018855816

Hypocomplementemic Urticarial Vasculitis Syndrome is Associated with High Levels of Serum IgG4: A Clinical Manifestation that Mimics IgG4-related Disease

Wakamatsu Ryo,Watanabe Hitoshi,Suzuki Keisuke,Suga Norihiro,Kitagawa Wataru,Miura Naoto,Nishikawa Kazuhiro,Yokoi Toyoharu,Banno Syogo,Imai Hirokazu
Internal Medicine 50(10), 1109-1112, 2011
… A 58-year-old Japanese woman presented with recurrent abdominal pain, chronic urticaria, and petechiae on her extremities, and hypocomplementemia, findings that were consistent with hypocomplementemic urticarial vasculitis syndrome (HUVS). …
NAID 130000649583