Skin, collagen, and blood vessels are essential elements in the hemostatic system. Any abnormality, inherited or acquired, in any one of these components of the vascular system will lead to mucosal bleeding such as: purpura, petechia, ecchymoses, or telangiectasia (Fig. 16.3). Tests of platelet function and numbers in these individuals will be normal. Senile purpura is a condition of aging in which skin loses its elasticity. Oftentimes, older individuals will bruise more easily and more prominently. Allergic purpura is seen in rare childhood disorders such as Henoch-Schonlein purpura, an immune complex disease that involves the skin, gastrointestinal tract, heart, and central nervous system. The purpura is often seen in the lower extremities. Purpura may occur due to infectious agents such as meningococcemia, Rocky Mountain spotted fever, staphylococci, or streptococcal infections.23 Conditions such as amyloidosis, vitamin C deficiency (scurvy), or Cushing syndrome may result in purpura.
Inherited collagen disorders provoking the formation of purpuric lesions or telangiectasia are hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease), an autosomal dominant disorder of the blood vessels. In this condition, small pinpoint hemorrhagic lesions are seen on the tongue, roof of the mouth, palate, face, and hands.23 In addition to these lesions, nosebleeds are prominent and the lesions in general become more fragile with age. Kasabach-Merritt syndrome is a rare congenital disorder featuring giant hemangiomas,23 bleeding, and thrombocytopenia. Hemangiomas may be found on the liver, skin, or spleen, and they are deep and bleed easily and profusely. DIC may develop if thromboplastic substances are released when the blood vessels burst.
Table 16.5 Q Modified List of
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Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.