Spots that don't disappear when pressed: a key feature of purpura (skin vasculitis)

Most people are surprised when they suddenly develop lesions on their legs that look like red spots or bruises.

At this time, whether the color disappears when pressed by hand is a very important point of discrimination.

If the color does not disappear when pressed, it may be a blood vessel problem rather than a skin problem.

 

What is purpura (cutaneous vasculitis)?

Purpura is a condition in which blood vessels become inflamed, their walls loosen, and red blood cells leak out of the blood vessels, causing red spots to appear on the skin.

The most common form is HS purpura (IgA vasculitis), which occurs mainly on the legs and is often painless and itchy.

Why doesn't the color disappear when I press it? (Difference from erythema)

• Erythema: vascular not A state where blood rushes to the area and it appears red → When pressed, it turns white, and when you remove your hand, it turns red again

• Purpura: blood vessels Outside It comes out and is in a stagnant state → The color is maintained no matter how much you press it

This difference alone helps us make a primary distinction.

How is it different from senile purpura?

• senile purpura

  • Areas that are frequently exposed to sunlight, such as the arms and back of the hands

  • The skin becomes thinner and even the slightest irritation causes it to look like a bruise.

  • Usually improves naturally within 1 to 2 weeks

  • Using steroid ointment may actually make the condition worse.

• HS purpura

  • Occurs mainly on the legs from the ankles to below the knees

  • The color doesn't disappear even when I press it.

  • Caused by vascular inflammation

The Principle of HS Purpura: 'Type 3 Immune Response'

HS purpura is associated with a type 3 immune response.

1. About colds, viruses, bacteria, drugs, food, pollutants, etc.

2. The body produces antibodies → combines with antigens to form immune complexes

3. These lumps can become lodged in peripheral capillaries (especially in the legs) and cause inflammation.

4. Blood vessel walls become loose and blood leaks out, forming purpura.

This also explains why they tend to form on the legs due to the influence of gravity.

Let's check these points together

• Have you had a cold or infection recently?

• Have you taken any new medications, such as nutritional supplements or painkillers?

• Does it recur after eating certain foods?

• Exposure to environmental factors such as fine dust

If the cause can be identified, improvement can be expected simply by avoiding exposure.

Are there any complications?

Most often limited to skin symptoms, but rarely:

• Kidney: Hematuria (confirmed by urine test)

• Joints: Joint pain

• Stomach: Abdominal pain
  Symptoms may be accompanied by back pain, so if you experience any of these symptoms, you should consult a medical professional.

How to help manage your life

• Medical elastic stockings: Wear on days when you stand for long periods of time or walk a lot.

• Leg raises: Elevate your legs above your heart while resting.

• Avoid suspected causative substances

These methods may help relieve symptoms and prevent relapse.

It may look like vitiligo, but there are other cases as well.

• Plaque-like vasculitis: mesh-like, pain, and possible necrosis → different treatment approach

• Delusional erythema: A physiological phenomenon that appears in cold weather and disappears when it gets warm.

Even if the appearances appear similar, the causes and responses may be different.

organize

• Red spots that don't disappear even when pressed → Consider the possibility of purpura

• HS purpura is a vascular inflammation caused by immune complexes.

• Identifying the cause and managing your lifestyle are important.

• Differentiation from other diseases that appear similar is necessary.

If sudden spots recur or are accompanied by other symptoms, it is safer to consult a specialist rather than trying to judge on your own.