Retiform purpura
From Wikipedia, the free encyclopedia
| Retiform purpura | |
|---|---|
| Specialty | Dermatology |
| Symptoms | persistent dark red to dark purple hemorrhagic skin patches or plaques |
| Causes | vessel wall damage (vasculitis/depositional disease/angioinvasion by organism) or vessel lumen occlusion (thrombotic or embolic disease)[1] |
| Treatment | Underlying cause and would care including circulatory support |
Retiform purpura is the result of total vascular blockage and damage to the skin's blood vessels. The skin then shows lesions, appearing due to intravascular issues where clots, proteins, or emboli block skin vessels. They can also result from direct harm to the vessel walls, as seen in conditions like vasculitis, calciphylaxis, and certain severe opportunistic infections.
Retiform purpura is a cutaneous morphology characterized by a branching (reticular), non-blanching (purpuric) patch, plaque, or lesion that develops when blood vessels supplying the skin become obstructed.[2][3] This blockage leads to downstream cutaneous ischemia, or insufficient blood supply to the skin, causing purpura, necrosis, and potentially ulceration.[3] The obstruction in the dermal and subcutaneous vasculature results in hemorrhage secondary to skin ischemia, which can further lead to skin necrosis and ulceration.[2][3][4] This morphology can occur in a variety of disorders.[5]
Signs and symptoms
Retiform purpura can present as non-raised large patches of purpura, with angulated or net-like border. They can present as painful dark red or purple patches or plaques with bordering branching and central purpura, necrosis, and/or ulceration. They can vary in size from small (1–2 cm) to large (>10 cm), and may be single or multiple, localized or disseminated. The branching may only be seen at the edge of one or two lesions but is still the clue to this diagnosis and a potentially serious underlying condition.[2] Inflammatory retiform purpura consists of redness around the lesion with associated central necrosis caused by vasculitic or infectious processes. Noninflammatory retiform purpura refers to lesions with central necrosis with surrounding redness caused by the occlusive process. There can be significant overlap between these two classifications. Pain within lesions is common and may be severe.[citation needed]
