DD of purpura

Q: How the purpura of thrombocytopenia and purpura of vasculitis can be differentiated on physical exam?

Answer: Physical exam plays an integral role in differentiating purpura from thrombocytopenia and vasculitis.

Purpura secondary to thrombocytopenia 

• flat 
• non-blanching 
• in dependent areas

Purpura secondary to vasculitis 

• palpable 
• pruritic
• does not follow dependent areas

#hematology

#physical-exam

#rheumatology

References:

1. 1. KAWAKITA Y. [MEDICAL EXAMINATION AND TREATMENT OF PURPURA]. Nihon Ishikai Zasshi. 1964 Mar 1;51:781-809. Japanese. PMID: 14144733.

2. Stevens GL, Adelman HM, Wallach PM. Palpable purpura: an algorithmic approach. Am Fam Physician. 1995 Oct;52(5):1355-62. PMID: 7572558.