Purple skin Assessment Questionnaire

Why: to determine if acute or chronic.

Why: A purple or blue-purple skin coloring is sometimes described as blueness or redness, and some conditions causing purple coloring may also be listed under blueness, cyanosis, redness, hyperpigmentation or dark skin. See cyanosis.

Why: may assist in diagnosis e.g. reddish purple flush around the eyes associated with swelling is characteristic of dermatomyositis.

Why: suggests port wine stain or strawberry nevus.

Why: e.g. blood in urine, heavy menstrual periods, bleeding nose, bleeding gums, swollen painful joints, rectal bleeding? - suggests presence of a systemic bleeding defect.

Why: e.g. purpura ( multiple small hemorrhages into the skin or mucous membranes); petechiae (small pinhead size purpura); ecchymoses ( large purpura).

Why: if palpable it suggests due to an underlying vasculitis affecting small vessels e.g. polyarteritis nodosa; if not palpable it suggests due to a platelet defect.

Why: suggests a disturbance of coagulation.

Why: suggests the presence of a systemic bleeding defect.

Why: if immediate suggests platelet defect; if delayed i.e. 24 hrs after trauma it suggests a coagulation factor deficiency.

Why: e.g. tooth extraction, circumcision, pregnancy - if normal response, suggests an acquired not inherited problem.

Why: may suggest acute Immune thrombocytopenic purpura (ITP) especially in children.

Why: Acquired bleeding disorders which may cause purple colored bruising can occur with liver disease, renal failure, lupus erythematosus and some cancers such as Multiple myeloma, myelofibrosis; sarcoidosis; dermatomyositis; HIV infection.

Why: Acquired bleeding disorders which may cause purple colored bruising may be due to certain prescribed medications e.g. aspirin, non-steroidal anti-inflammatory medication, anticoagulant therapy, thiazide diuretics, chloramphenicol, cancer chemotherapy drugs, gold, heparin, quinine, quinidine, sulphonamides.

Why: may help determine risk of HIV which is associated wih Kaposi's sarcoma.

Why: may indicate central cyanosis which is due to a lack of oxygenated hemoglobin in the blood vessels and thus may indicate high altitude, emphysema, chronic bronchitis, pulmonary embolism, cyanotic congenital heart disease, polycythaemia or hemoglobin abnormalities. Any cause of central cyanosis can also cause peripheral cyanosis and thus blue skin.

Why: may indicate exposure to cold, left ventricular failure, shock, arterial obstruction, venous obstruction or any of the causes of central cyanosis.

Why: e.g. shortness of breath, cough, tiredness, skin symptoms occur in 10% of cases and may include purple or brown plaques or nodules on face, nose, ears and neck in chronic sarcoidosis.

Why: e.g. muscle weakness, muscle tenderness, muscle pain, purple colored rash on face (especially on the eyelids, upper cheeks and forehead), swelling round the eyes, red rashes, pain in joints, Raynaud's phenomenon, difficulty swallowing, fever, weight loss, tiredness.

Why: e.g. mildly elevated pink, purple or red spots or patches on the skin that may be round or oval appearing first on the upper body or in the mouth. They are associated with lymph node enlargement.

Why: e.g. deep purple-red discoloration due to benign abnormal growth of the skin blood vessels; commonly occurring on the face and on the junctions between the limbs and the trunk (i.e. shoulders, neck, buttocks).