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British Medical Journal Jul 1954
Topics: Anemia; Anemia, Hemolytic; Blood Vessels; Disease; Humans; Purpura; Purpura, Thrombocytopenic; Thrombocytopenia
PubMed: 13172478
DOI: 10.1136/bmj.2.4879.81 -
Anais Brasileiros de Dermatologia Jun 2018Purpura is defined as a visible hemorrhage in the skin or mucosa, which is not evanescent upon pressure. Proper classification allows a better patient approach due to... (Review)
Review
Purpura is defined as a visible hemorrhage in the skin or mucosa, which is not evanescent upon pressure. Proper classification allows a better patient approach due to its multiple diagnoses. Purpuras can be categorized by size, morphology, and other characteristics. The course varies according to the etiology, as do the diagnostic approach and treatment. This review discusses pigmented purpuras and some cutaneous vascular occlusion syndromes.
Topics: Antiphospholipid Syndrome; Calciphylaxis; Diagnosis, Differential; Humans; Pigmentation Disorders; Purpura; Purpura Fulminans; Skin; Skin Diseases, Vascular; Syndrome
PubMed: 29924250
DOI: 10.1590/abd1806-4841.20187459 -
British Journal of Haematology Apr 2017The management of patients with immune thrombocytopenia (ITP) is rapidly evolving. Over the last 15 years, a number of novel treatments have improved practice, with... (Review)
Review
The management of patients with immune thrombocytopenia (ITP) is rapidly evolving. Over the last 15 years, a number of novel treatments have improved practice, with many steroid-sparing agents and a reduction in the progression to splenectomy. Although this has improved clinical care, many therapeutic challenges remain. There is no diagnostic test, no biomarkers to direct treatment and few comparative studies to help management decisions. Development of up to date guidelines is difficult with little high-grade evidence. First line treatment continues to be steroids and intravenous immunoglobulins (IVIG) although both are often poorly tolerated and not curative. Common second line treatments include rituximab, immunosuppressive agents, such as azathioprine and mycophenolate mofetil, and the thrombopoietin receptor agonists romiplostim and eltrombopag. There are no comparative studies to decide between these agents and treatment is generally individualized, depending on comorbidity. Use of splenectomy has declined and is generally reserved for patients with chronic disease, although the exact position of splenectomy is subject to debate. Further understanding of the cause of disease in individual patients may help guide treatment. Randomized controlled studies of common treatments and novel treatments for refractory patients are urgently needed.
Topics: Clinical Decision-Making; Decision Trees; Disease Management; Humans; Practice Guidelines as Topic; Purpura, Thrombocytopenic, Idiopathic
PubMed: 28295192
DOI: 10.1111/bjh.14515 -
Dermatologic Therapy Apr 2022
Topics: COVID-19; COVID-19 Vaccines; Humans; Purpura; Vaccination
PubMed: 35137500
DOI: 10.1111/dth.15360 -
Journal of Cosmetic Dermatology Jan 2023COVID-19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. COVID-19 outbreak, which caused thousands of... (Review)
Review
BACKGROUND
COVID-19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. COVID-19 outbreak, which caused thousands of deaths, has been declared a pandemic by the World Health Organization in March 2020.
AIM
Skin manifestations related to SARS-CoV-2 infection can be divided mainly into five groups: chilblainlike lesions (CBLLs), maculopapular eruptions, urticarial eruptions, vesicular eruptions, and livedo or necrosis. Other skin findings reported are erythema multiforme (EM)-like lesions and skin findings associated with multisystem inflammatory syndrome in children (MIS-C) and rarely with multisystem inflammatory syndrome in adults (MIS-A). Other manifestations such as pityriasis rosea or shingles are also reported.
METHODS
A total of 60 articles including reviews, studies and case reports were selected for the evaluation in this review.
RESULTS
The skin manifestations associated with COVID-19 infection are numerous and can vary widely. The major dermatological patterns of COVID-19 can be classified as inflammatory reactions (maculopapular/morbilliform, urticarial and vesicular rashes), or lesions of vascular origin (chilblain like rashes, petechiae/purpura, and livedo acemose-like pattern) CONCLUSION: We believe that the dermatologist could play an important role in the response to the SARS-CoV-2 pandemic through early recognition of skin lesions suggestive of COVID-19, particularly in paucisymptomatic infections where this recognition could direct toward an early diagnosis of infection that certainly leads to a better prognosis.
Topics: Adult; Child; Humans; COVID-19; SARS-CoV-2; Skin Diseases; Purpura
PubMed: 36342945
DOI: 10.1111/jocd.15477 -
Canadian Medical Association Journal Jul 1969
Review
Topics: Adrenal Cortex Hormones; Aminocaproates; Anesthesia, Conduction; Blood Transfusion; Chickenpox; Child; Dextrans; Female; Fibrinogen; Ganglia, Autonomic; Heparin; Humans; Hyperbaric Oxygenation; Purpura; Shwartzman Phenomenon
PubMed: 4893497
DOI: No ID Found -
Blood Jan 2023
Topics: Humans; Purpura, Thrombotic Thrombocytopenic; Plasma Exchange; Recurrence; Chronic Disease
PubMed: 36656610
DOI: 10.1182/blood.2022019297 -
Archives of Dermatological Research Mar 2023Levamisole exposure in cocaine users is a well-recognized cause of retiform purpura, a distinctive net-like maculopapular patch. Prolonged exposure to levamisole... (Review)
Review
Levamisole exposure in cocaine users is a well-recognized cause of retiform purpura, a distinctive net-like maculopapular patch. Prolonged exposure to levamisole can lead to a serious systemic syndrome known as levamisole-induced vasculitis, most commonly involving the kidneys and lungs. More recently, retiform purpura has been observed in patients with the novel coronavirus disease of 2019 (COVID-19). Due to their overlapping dermatologic and systemic manifestations, levamisole-induced and COVID-19-induced retiform purpura may mimic one another in clinical presentation. The possibility that patients may present with one or both syndromes creates a diagnostic challenge. This review of levamisole-induced and COVID-19-induced retiform purpura highlights their corresponding and distinctive features. Additionally, we propose a unique staging system for levamisole-induced retiform purpura that may be valid for future classification of COVID-19-induced retiform purpura.
Topics: Humans; COVID-19; Levamisole; Purpura
PubMed: 34807290
DOI: 10.1007/s00403-021-02303-1 -
Seminars in Hematology Jan 2009Primary immune thrombocytopenic purpura (ITP) remains a diagnosis of exclusion both from nonimmune causes of thrombocytopenia and immune thrombocytopenia that develops... (Review)
Review
Primary immune thrombocytopenic purpura (ITP) remains a diagnosis of exclusion both from nonimmune causes of thrombocytopenia and immune thrombocytopenia that develops in the context of other disorders (secondary immune thrombocytopenia). The pathobiology, natural history, and response to therapy of the diverse causes of secondary ITP differ from each other and from primary ITP, so accurate diagnosis is essential. Immune thrombocytopenia can be secondary to medications or to a concurrent disease, such as an autoimmune condition (eg, systemic lupus erythematosus [SLE], antiphospholipid antibody syndrome [APS], immune thyroid disease, or Evans syndrome), a lymphoproliferative disease (eg, chronic lymphocytic leukemia or large granular T-lymphocyte lymphocytic leukemia), or chronic infection, eg, with Helicobacter pylori, human immunodeficiency virus (HIV), or hepatitis C virus (HCV). Response to infection may generate antibodies that cross-react with platelet antigens (HIV, H pylori) or immune complexes that bind to platelet Fcgamma receptors (HCV), and platelet production may be impaired by infection of megakaryocyte (MK) bone marrow-dependent progenitor cells (HCV and HIV), decreased production of thrombopoietin (TPO), and splenic sequestration of platelets secondary to portal hypertension (HCV). Sudden and severe onset of thrombocytopenia has been observed in children after vaccination for measles, mumps, and rubella or natural viral infections, including Epstein-Barr virus, cytomegalovirus, and varicella zoster virus. This thrombocytopenia may be caused by cross-reacting antibodies and closely mimics acute ITP of childhood. Proper diagnosis and treatment of the underlying disorder, where necessary, play an important role in patient management.
Topics: Humans; Purpura, Thrombocytopenic, Idiopathic
PubMed: 19245930
DOI: 10.1053/j.seminhematol.2008.12.005 -
International Journal of Molecular... Feb 2024Pigmented purpuric dermatoses (PPD) encompass a group of chronic skin conditions characterized by the presence of petechiae, purpura, and pigmentation changes. While... (Review)
Review
Pigmented purpuric dermatoses (PPD) encompass a group of chronic skin conditions characterized by the presence of petechiae, purpura, and pigmentation changes. While generally benign, these dermatoses can be persistent and aesthetically bothersome. Key clinical features include red to brownish patches with a distinctive "cayenne pepper" appearance, predominantly localized on the lower extremities, particularly the shins. Subtypes include Schamberg disease, Majocchi's disease, Gougerot-Blum disease, Ducas and Kapetanakis pigmented purpura, and lichen aureus. Diagnosis relies primarily on clinical evaluation of skin lesions, with biopsy as a confirmatory tool. Although the exact cause of PPD remains unclear, capillary fragility and red blood cell extravasation are implicated. Treatment strategies for PPD aim to alleviate symptoms, considering the generally benign and chronic nature of the condition. As there is no standardized treatment, various methods with varying efficacy are employed. After searching SCOPUS and PubMed databases, we assessed 42 original articles to present current knowledge regarding therapy of PPD. This review will compare treatment approaches specifically in Schamberg disease and other manifestations of pigmented purpuric dermatoses.
Topics: Humans; Pigmentation Disorders; Skin Diseases; Purpura; Eczema; Vascular Diseases
PubMed: 38473891
DOI: 10.3390/ijms25052644