Purpura Simplex

PURPURA SIMPLEX Purpura simplex is characterized by slight blood sations into the skin only. These appear dui t e unexpectedly, or they are pated by certain cursors several clays in advance, such as headache, anorexia, lassitude, v o mi t i n g. The maculae have the size of a pinhead to a lentil, are of lar shape, resembling fleabites or weals; they are isolated and do not coalesce. The fresh maculae are dark red or bluish red, ter some time they become paler and pass through the various stages of the blood-pigment. In some of them there is a palpable indurated spot in the centre (fibrinous coagulation). They do not disappear on pressure. In their distribution they show a predilection for certain parts of the body; thus the face and usually the hands also are left free, while a preference is shown for the extensor surfaces of the lower extremities and the arms; as they extend further, they invade also the trunk. The eruption occurs either all at once or advances by jumps.

In the latter case macules of every age may be noticed side by side.

The general condition is usually not disturbed at all; prodromal manifestations, should such exist, usually disappear with the eruption. Fever, as a rule, is absent..

There are sometimes deviations in the exanthem to such an extent that the petechite are infiltrated like oedematous xvheals—purpura urti cans (Biedert). Further, a true urticaria or exudative eczema may develop side by side with the maculae of the purpura.

Course and duration of the pathological process depends upon whether the petechite appear practically at the same time or at more or less distant intervals. In the former case eight to twelve clays are reckoned to effect a cure, in the latter case it may require weeks or months. The termination is always favorable; only where there is considerable extension of hmmorrhage and a prolonged duration of the affection, there may be manifestations of anemia.