Team AckoSept 21, 2023
Human skin is a complex organ made up of many layers. One part of this structure includes hundreds of tiny blood vessels that are normally invisible. However, if they rupture, bleeding in the skin can be seen as small red dots called Petechiae (PTC). These small spots are usually seen on the hands, legs, glutes, or stomach. However, they can also appear inside the mouth. These are mostly seen in children and could indicate the presence of an infection or blood disorder.
Petechiae refers to a site of bleeding or haemorrhage from a capillary. The tiny blood vessels right under the surface of the skin and mucous membranes are capillaries. When a capillary ruptures or breaks, it bleeds and leaks into the skin. This appears as tiny, reddish-purple spots called PTC. They are usually less than 2 mm in diameter. A characteristic feature of PTC is that they are non-blanching, that is, when you apply pressure on these spots, they do not lighten in colour or disappear.
There are many causes for Petechiae to form. They can be classified into the following groups.
Physical trauma & straining
Side effects of medications
Miscellaneous non-infectious medical conditions
Let us look at each of these causes briefly.
The most common cause of PTC forming is prolonged straining during forceful activities, such as violent coughing, retching, vomiting, crying, childbirth, weightlifting, asphyxiation & physical abuse. These generally result in the formation of PTC around the eyes, on the face, neck, & chest.
Many infections can result in the formation of tiny petechial rashes over the body. You may have seen this, especially after viral infections like dengue. When seeing a doctor, it is helpful to inform them about how and where the rashes started, and their pattern of spread.
Some infections that can present with petechial rashes include the following.
Meningitis caused by meningococcal bacteria
Infectious mononucleosis (mono or kissing disease)
In most of these conditions, the rash presents along with features of infection like fever, headache, generalised malaise and fatigue, and other systemic signs.
Any defect in platelets or the clotting mechanism of blood can cause Petechiae. Some of these conditions include the following.
Thrombocytopenia (decrease in platelet count)
Clotting factor deficiencies (example, von Willebrand disorder)
Idiopathic Thrombocytopenic Purpura (ITP)
Splenomegaly (enlargement of the spleen)
Leukaemia (a cancerous condition where there is an excess of white blood cells)
These conditions are rare, and never present isolated with just Petechiae, and the other symptoms of these diseases will prompt you to seek medical intervention immediately.
Some medications can produce petechial rashes as a side effect. This is more common in people taking multiple drugs that may interact. Some drugs which cause Petechiae as a side effect include penicillin, some anti seizure medications, and blood thinners.
1. Nutritional deficiencies
Children with severe malnutrition can present with petechial rashes over their bodies. Some vitamin deficiencies can cause petechial rashes. They include the following.
Vitamin C deficiency: Although severe Vitamin C deficiency (or scurvy) is rare these days, it can present with a petechial rash and malaise, loosening of teeth, gum disease, and bone pain.
Vitamin K deficiency: Vitamin K is important for the production of chemicals called clotting factors which are necessary for wound healing and arrest of bleeding. In vitamin K deficiency, the patient may bruise easily and have petechial rashes.
2. Chronic Liver Disease
One of the important functions of the liver is producing clotting factors. In the absence of clotting mechanisms, even small superficial injuries (like bumps, itching, scratching, etc.) can cause easy bruising and the small capillaries to break.
This is a broad term that means inflammation of blood vessels. Some of these conditions can initially present with petechial rashes.
The treatment for Petechiae depends on the underlying cause. The good news is that most of these causes are not life-threatening and the rash will clear on its own. Make sure to get some rest and drink plenty of fluids. Taking over-the-counter painkillers like paracetamol may also help.
Doctors may advise treatment such as the following.
Antibiotics, antivirals, or antiparasitic agents in case of infections
Stopping medications known to cause such rashes
Antiinflammatory agents such as steroids
Chemotherapy in case of blood cancer
It is always good to see your doctor if you or your child suddenly develop petechial rashes over your body that are not explained by any event that has happened recently (that is, any event of physical straining). Most of the time it is not worrisome and disappears on its own. However, if there is a more serious cause to it, an early diagnosis is always helpful in managing the situation better.
In case of any of these symptoms, visit a doctor at the earliest.
Petechiae that are increasing in size or number and spreading rapidly
Loss of consciousness
Bleeding from other sites such as the gums or the nose
Although PTC indicates bleeding, most of the causes are easily treatable. Avoid rubbing or scratching them. In most cases, these pinpoints will clear on their own without leaving behind any marks or scars. If you have a bleeding disorder, PTC may be an almost constant presence on your skin. However, if they appear suddenly and you have no idea why, do consult a doctor.
As infections are one of the most common pathological causes of Petechiae, steps taken to prevent infections can be helpful. These include the following.
Washing hands with soap and water
Avoiding contact with people who are sick
Staying away from stagnant water
Safe sex practices such as using a condom
Physical protection and insect repellants when going outdoors for treks, etc.
Maintaining good dental hygiene
Limiting alcohol consumption
In case you have a history of developing petechial rashes after taking certain medications, make sure to inform your doctor about the same.
There are many conditions that result in fragility of blood vessels or difficulty in blood clotting. These can result in repeated episodes of PTC, especially in people whose jobs involve physical strain such as lifting weights.
PTC by themselves do not cause any complications. However, they can indicate serious underlying conditions that may cause problems if left untreated.
Yes, simple home measures to help PTC resolve quickly include taking rest, drinking oral fluids, taking painkillers such as ibuprofen or paracetamol and applying an ice pack for about 15 to 20 minutes. This is especially helpful if PTC appears after chronic cough or retching in patients with other diseases of the chest or digestive system.
Do not attempt to rub PTC or apply any substances such as baking soda or lemon and tomato juice. The spots will fade over time on their own. Consult a doctor and follow the advice given.
Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions. Petechiae is written as PTC in this article.
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