How to distinguish purpura from hemorrhagic spots

Bleeding spots are a symptom of a disease, not a separate disease. Purpura is a term for a disease in traditional Chinese medicine. Purpura can cause bleeding spots. The causes of bleeding spots are not only due to purpura, but also related to poor coagulation mechanism and low platelet count. Therefore, when subcutaneous bleeding spots appear, you should go to the hospital for examination in time to see what the cause is, and then receive regular treatment.

Subcutaneous hemorrhage

1. Main types: 1. Bleeding with a diameter of less than 2 mm is called a bleeding spot; 2. Bleeding with a diameter of 2 to 5 mm is called purpura; 3. Bleeding with a diameter greater than 5 mm is called ecchymosis; and patchy bleeding with obvious protrusions is called hematoma.

2. The main cause is vascular factors: skin and mucous membrane bleeding caused by congenital or acquired defects in the blood vessel wall. For example, hereditary hemorrhagic telangiectasia, due to increased local fragility of blood vessels, often causes repeated bleeding in the same area; Henoch-Schönlein purpura is a capillary allergic disease, due to the deposition of antigen-antibody complexes on the blood vessel walls, causing capillary dilation and increased permeability, leading to purpura or bleeding; the elderly are prone to senile purpura due to loose tissues and increased fragility of blood vessel walls. Platelet Factors Platelets play an important and complex role in hemostasis. When the number or quality of platelets is abnormal, it often leads to bleeding of the skin and mucous membranes. In severe cases, there may be internal bleeding, such as bleeding in the digestive tract, urinary tract, respiratory tract, uterus, and even brain. Coagulation and anticoagulation factors Lack of coagulation factors or excess of anticoagulation factors in the blood can also cause large bruises on the skin, but deep hematomas or joint bleeding are generally more common. Frequent subcutaneous bleeding often indicates a bleeding disease. Patients should go to the hospital in time to further find out the cause and receive treatment accordingly. Subcutaneous bleeding can also occur during diving. Some divers inhale more oxygen due to high pressure when working in deep water. The oxygen liquefies in the blood and the oxygen content in the body increases. When a diver ascends, the pressure decreases due to his rapid ascending speed, and the oxygen inhaled vaporizes instantly, causing excessive pressure on the inner walls of the capillaries, bursting the blood vessels and causing internal bleeding. This was often the case with early diving accidents.

Purpura

1. The cause of purpura is mainly in the blood, and can be divided into deficiency and excess. The external cause is the exogenous wind-heat evil, which brings dampness, heat and poison into the blood on the skin surface, forcing the blood to flow abnormally and overflow into the skin pores, mainly manifesting as a positive symptom. The internal cause is insufficient qi and blood in the heart and spleen, deficiency of kidney yin, ascending of virtual fire, and failure of blood to return to the meridians, with deficiency syndrome being the main symptom.

2. Differential diagnosis should pay attention to distinguishing whether the disease is allergic purpura or thrombocytopenic purpura. 1. Allergic purpura may be preceded by upper respiratory tract infection or taking certain medications, foods, and other triggers. Purpura is often seen on the extensor side of the lower limbs, buttocks, and around the joints. It is bright red to dark red papules, erythema or urticaria that are raised above the skin. They vary in size, are mostly symmetrical, appear in batches, and do not fade when pressed. It may be accompanied by gastrointestinal symptoms such as abdominal pain, vomiting, bloody stools, migratory swelling and pain in large joints, hematuria, proteinuria, etc. Platelet count, bleeding and clotting time, and clot retraction time were all normal. Attention should be paid to regular urine routine examinations, as microscopic hematuria and proteinuria are often found. 2. Thrombocytopenic purpura may cause petechiae and ecchymoses on the skin and mucous membranes. The petechiae are mostly needle-sized, usually not protruding above the skin surface, and are mostly asymmetrical. They can be found all over the body, but are more common on the limbs, head and face. It may be accompanied by epistaxis, bleeding from the teeth, hematuria, bloody stool, etc. In severe cases, intracranial hemorrhage may occur. The platelet count is significantly reduced, the acute type is generally lower than 20 times 109 times/L, and the chronic type is generally between 30x109 times/L-80X109 times/L. Bleeding time is prolonged, blood clot retraction is poor, and the clot test is positive.