vascular purpura

血管性紫斑病

WordNet

1. of or relating to or having vessels that conduct and circulate fluids; "vascular constriction"; "a vascular bundle"
2. any of several blood diseases causing subcutaneous bleeding (同)peliosis

PrepTutorEJDIC

1. (血液・樹液などを運ぶ)管の,導管の,血管の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/13 09:15:11」(JST)

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For other uses of "Purpura", see Purpura (disambiguation).

Purpura
Classification and external resources
Petechiae and purpura on the low limb due to medication induced vasculitis
ICD-10	D69
ICD-9	287
DiseasesDB	25619
MedlinePlus	003232
MeSH	D011693

Purpura (from Latin: purpura, meaning "purple") is the appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin usually secondary to vasculitis or dietary deficiency of vitamin C (scurvy). Purpura measure 0.3–1 cm (3–10 mm), whereas petechiae measure less than 3 mm, and ecchymoses greater than 1 cm.

This is common with typhus and can be present with meningitis caused by meningococcal meningitis or septicaemia. In particular, meningococcus (Neisseria meningitidis), a Gram-negative diplococcus organism, releases endotoxin when it lyses. Endotoxin activates the Hageman factor (clotting factor XII), which causes disseminated intravascular coagulation (DIC). The DIC is what appears as a rash on the affected individual.

Classification

Purpura are a common and nonspecific medical sign; however, the underlying mechanism commonly involves one of the following:

• Platelet disorders (Thrombocytopenic purpura)
  • Primary thrombocytopenic purpura
  • Secondary thrombocytopenic purpura
  • Post-transfusion purpura
• Vascular disorders (nonthrombocytopenic purpura)
  • Microvascular injury, as seen in senile (old age) purpura, when blood vessels are more easily damaged
  • Hypertensive states
  • Deficient vascular support
  • Vasculitis, as in the case of Henoch-Schönlein purpura
• Coagulation disorders
  • Disseminated intravascular coagulation (DIC)
  • Scurvy (vitamin C deficiency) - defect in collagen synthesis due to lack of hydroxylation of procollagen results in weakened capillary walls and cells
• Meningococcemia
• Cocaine use with concomitant use of the one-time chemotherapy drug and now veterinary deworming agent levamisole can cause purpura of the ears, face, trunk, or extremities, sometimes needing reconstructive surgery. Levamisole is purportedly a common cutting agent
• Decomposition of blood vessels including purpura are a symptom of acute radiation poisoning in excess of 2 Grays of radiation exposure. This is an uncommon cause in general but is commonly seen in victims of nuclear disaster.

There are also cases of psychogenic purpura described in the medical literature, some claimed to be due to "autoerythrocyte sensitization". Other studies suggest the local (cutaneous) activity of tPA can be increased in psychogenic purpura, leading to substantial amounts of localized plasmin activity, rapid degradation of fibrin clots, and resultant bleeding. Petechial rash is also characteristic of a rickettsial infection.

See also

• Bruise, which is a hematoma caused by trauma
• Petechia, which is a small type of hematoma (<3mm)
• Ecchymosis, which is a large type of hematoma (>1 cm)
• Purpura secondary to clotting disorders
• Food-induced purpura
• Purpura haemorrhagica in horses
• Pigmented purpuric dermatosis
• Schamberg disease (progressive pigmentary purpura)

References

External links

• Evaluating the Child with Purpura from American Academy of Family Physicians

UpToDate Contents

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• 1. 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
• 2. 成人の血管炎の分類とそれに対するアプローチ classification of and approach to the vasculitides in adults
• 3. 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
• 4. 小児における紫斑の評価 evaluation of purpura in children
• 5. 心因性紫斑病（ガードナーダイヤモンド症候群） psychogenic purpura gardner diamond syndrome

English Journal

• [Localized purpura revealing vascular prosthetic graft infection].

• Boureau AS1, Lescalie F, Cassagnau E, Clairand R, Connault J.
• Journal des maladies vasculaires.J Mal Vasc.2013 Jul;38(4):276-9. doi: 10.1016/j.jmv.2013.04.012. Epub 2013 Jun 6.
• Prosthetic graft infection after vascular reconstruction is a rare but serious complication. We report a case of infection occurring late after implantation of an iliofemoral prosthetic vascular graft. The Staphylococcus aureus infection was revealed by vascular purpura localized on the right leg 7
• PMID 23746928

• An atypical temporal sequence for right heart endocarditis: case report.

• Manea P.
• The heart surgery forum.Heart Surg Forum.2013 Jun;16(3):E144-6. doi: 10.1532/HSF98.20121119.
• In 2010, an 82-year-old patient received a diagnosis of stage IV chronic obstructive pulmonary disease, ischemic dilated cardiomyopathy, severe secondary pulmonary hypertension, atrial fibrillation with slow ventricular response, and severe tricuspid regurgitation. In December 2011, he was hospitali
• PMID 23803237

• Vascular purpura revealing a severe dilated cardiomyopathy with left ventricular apical thrombus.

• Seemann A1, De Prost N, Paoletti MT, Sbidian E, Brun-Buisson C, Valeyrie-Allanore L.
• Journal of cardiovascular disease research.J Cardiovasc Dis Res.2012 Oct;3(4):326-8. doi: 10.4103/0975-3583.102724.
• We present a case of vascular purpura revealing an intra-cardiac left-sided thrombus complicating an end-stage dilated cardiomyopathy. Vascular purpura main etiologies encompass the wide specturm of vasculitides and microvascular-occlusion syndromes. Among them, cardiac embolism represents an unusal
• PMID 23233780

Japanese Journal

• 大量の消化管出血を繰り返した結節性多発動脈炎の1剖検例

• 采田 憲昭,多田 修治,神尾 多喜浩,吉田 健一,古田 陽輝,上原 正義,江口 洋之,工藤 康一,塩屋 公孝,今村 治男
• 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 54(7), 2022-2031, 2012-07-20
• 症例は68歳，女性．下肢の紫斑と激しい上腹部痛のため，近医に入院．入院後23日目より嘔吐と大量下血を認め，当院に緊急転院となった．空腸からの大量出血を繰り返し，緊急手術となった．多彩な臨床症状と，空腸切除標本の病理組織学的検索により結節性多発動脈炎が疑われた．ステロイドパルス療法と内視鏡的止血術，カテーテルによる血管塞栓術を行ったが，大量の消化管出血と多臓器不全のために永眠され，病理解剖の結果，結 …
• NAID 10030961713

• 慢性維持透析者に発症したcalcific uremic arteriolopathy（CUA）の1例と病因・治療の検討

• 西銘 圭蔵,高嶺 朝広,中村 成男,金城 紀代彦,斉藤 保
• 日本透析医学会雑誌 45(7), 591-598, 2012
• 症例は44歳，男性．主訴は両下肢の先行する激痛後の皮膚の紫斑，壊死，潰瘍形成．既往歴は9年前，血液透析導入．現病歴は2008年2月，激しい痛みが先行した右下腿の皮膚の紫斑，小壊死，潰瘍が出現．壊死は周辺に広がる．同年6月，副甲状腺摘除（4腺摘除＋右前腕自家移植）．同年10月，都合8回の植皮を行う．皮膚生検による病理組織で細小動脈中膜への石灰沈着および石灰による血管内腔の完全閉塞が認められた．現在は …
• NAID 130002145585

• 慢性腎不全患者に発症したCalciphylaxisの1例

• 渡邊 成樹,山口 聡,小山内 裕昭 [他],村上 正基
• 泌尿器科紀要 56(10), 597-600, 2010-10-00
• … Calciphylaxis is characterized by progressive vascular calcification, soft tissue necrosis, and ischemic necrosis of the skin. … We present a 76-year-old man on hemodialysis who developed small, painful purpura on the thigh. … The purpura rapidly spread to his back and hip and became ulcerated. …
• NAID 120002576697

Related Links

• Purpura - Wikipedia, the free encyclopedia

Primary thrombocytopenic purpura; Secondary thrombocytopenic purpura; Post- transfusion purpura. Vascular disorders (nonthrombocytopenic purpura). Microvascular injury, as seen in senile (old age) purpura, when blood vessels are more ...

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★リンクテーブル★

リンク元	「血管性紫斑病」
関連記事	「vascular」「purpura」

「血管性紫斑病」

　　[★]

英

vascular purpura

• 血管障害により出血性素因を来す疾患の総称 (PED.804)
• アレルギー機序が関与する疾患：ヘノッホ・シェーンライン紫斑病
• YN.G-91によれば、アレルギー性紫斑病 = ヘノッホ・シェーンライン紫斑病 = 血管性紫斑病 のような記載

「vascular」

　　[★]

• adj.

• (生物・解剖)導管の、脈管の、血管の

関

angio、blood vessel、fibrovascular bundle、vascular bundle、vasculogenic、vein、vessel

　 　

「purpura」

　　[★]

• n.

• 紫斑、紫斑病