What are the common symptoms of simple purpura

Simple purpura, also known as the common female livedo syndrome, mainly affects women, which is related to the female menstrual cycle. After the onset of the disease, the patient's skin is prone to small raindrops and bruises of varying sizes. In addition, it may occur spontaneously after a minor trauma, often in the lower limbs and buttocks, and is prone to recurrence, especially during menstruation.

Common symptoms

1. It is more common in women. The clinical characteristics are small petechiae and ecchymoses of varying sizes on the skin, which are common in the lower limbs and buttocks. It recurs frequently and is prone to occur during the menstrual period. A small number of patients may have a positive arm restraint test.

2. It often occurs during the menstrual period in childhood and adolescent girls. Most of them have repeated bleeding spots or bruises on the skin of the lower limbs and buttocks. They are not raised on the skin surface and do not fade when pressed. After a few days or weeks, the purpura subsides and leaves blue or yellowish-brown pigmentation spots, which then gradually disappear. Skin purpura may reappear and occur repeatedly.

3. Simple purpura is occasionally seen on both upper limbs but not on the trunk. Some patients experience local skin pain when purpura appears, which is generally not severe. Some patients may also be caused by autosomal dominant inheritance, which is more common in women with a positive family history, called familial simple purpura.

4. The arm test may be positive, the screening tests of hemostasis function are normal, the capillary fragility test is positive, some patients may have abnormal platelet aggregation reaction induced by ADP and adrenaline, a few may have reduced platelet adhesion rate to glass beads, and anti-platelet antibodies are positive.

Differential diagnosis

1. Aspirin-like defects have uneven distribution of skin ecchymoses, obvious mucosal bleeding, and heavy bleeding from traumatic surgery, which should be differentiated. This disease is an autosomal dominant genetic disease with platelet release dysfunction. Patients are particularly sensitive to aspirin. Platelet counts and platelet aggregation reactions to inducing agents such as ADP are normal, but the effectiveness of platelet factor 3 (PF3) is abnormal.

2. There is a history of low fever, sore throat, general fatigue or upper respiratory tract infection 1-3 weeks before the onset of allergic purpura. The skin purpura is limited to the limbs, especially the lower limbs and buttocks, and the trunk is rarely affected. Purpura often occurs repeatedly in batches and is symmetrically distributed, and may be accompanied by skin edema and urticaria. Purpura varies in size and is dark red at first. It does not fade when pressed and can merge into pieces to form ecchymoses. It gradually turns into purple, yellowish brown, and light yellow within a few days and gradually disappears after 7-14 days. It may be accompanied by abdominal pain, joint swelling and pain, and hematuria; platelet count, function, and coagulation-related tests are normal.