Petechiae are pinpoint-sized hemorrhages of small capillaries in the skin or mucous membranes.
Petechiae result from tiny areas of superficial bleeding into the skin. They appear as round, pinpoint-sized dots that are not raised. The color varies from red to blue or purple as they age and gradually disappear. Petechiae commonly appear on the lower legs, but may be distributed all over the body.
There are many possible causes of petechiae. Common causes include:
There may be other causes of petechiae.
When a person has petechiae, the healthcare provider will ask questions, such as:
Other questions may also be asked.
Diagnosis of petechiae begins with the history and physical exam. Blood tests are usually done, including:
Platelets are blood cells that aid in blood clotting. If a person has too few of them in the blood, the person may be more likely develop petechiae. A bone marrow biopsy may be done in some cases.
It is not always possible to avoid petechiae. Avoiding trauma will help prevent petechiae caused by injury. If allergy to a medication is the cause, avoiding the medication will help prevent the condition. Prompt treatment of infections will help prevent sepsis.
The long-term effects of petechiae depend on the cause. For example, petechiae caused by injury will usually fade in time, and cause no long-term effects. When the cause is allergy to a medication, stopping the medication should end the condition. A person who has a severe infection with petechiae may be very ill, and death can occur.
Most cases of petechiae are not contagious and pose no risk to others. If the cause of petechiae is an infection, such as mononucleosis or meningitis, the infection may be contagious.
Treatment is directed at the underlying cause of the petechiae. For example, someone with petechiae caused by an infection is given antibiotics. If petechiae are caused by allergy to a medication, the medication may need to be stopped. A person with petechiae due to a low platelet count may need a transfusion of platelets or other blood factors. A person with leukemia or cancer may need surgery, chemotherapy, or radiation therapy. Petechiae caused by injury need no treatment. Applying an ice pack off and on for 24 hours after the injury may reduce further petechiae. The petechiae will fade in time.
All medications have possible side effects. Antibiotics can cause stomach upset, and sometimes an allergic reaction. Blood transfusions may cause allergic reactions or infections. Surgery poses a risk of infection, bleeding, and allergic reaction to anesthesia.
Most petechiae will disappear when the cause is identified and treated.
Blood tests may be done to see if the platelet count is back to normal. If petechiae worsen, or any other symptoms are present, monitoring by a healthcare provider may be necessary. Any new or worsening symptoms should be reported to the healthcare provider.
Author:Gail Hendrickson, RN, BS
Editor:Duff, Ellen, BA
Reviewer:Eileen McLaughlin, RN, BSN
Current Medical Diagnosis and Treatment, Tierney, 2000
The Merck Manual of Medical Information, 1997
Harrison's Principles of Internal Medicine, Fauci et al, 1998