Petechiae
Hello, doctor.
Today I woke up and suddenly noticed dark red or coffee-colored petechiae (like needle pricks) under the skin of my left arm.
The day before, I had a Thai oil massage that involved my arms, and later that night I ate a drunken chicken hot pot.
Could this be related? Additionally, I have a deviated septum, so the lower turbinate on the left side sometimes appears red due to microvascular changes.
When the weather is dry or when I blow my nose, there is occasionally slight bleeding, but it stops quickly.
A few days ago, while brushing my teeth, I noticed slight bleeding from my gums around my braces.
I visited the dentist, who mentioned that food can easily get trapped between the teeth next to the braces, leading to gum inflammation and bleeding.
I had blood tests done last August and December, and my platelet count was around 240, which is not low, but I still want to ask if this could be related to any purpura or blood disorders?
aqqqa, 20~29 year old female. Ask Date: 2013/01/18
Dr. Chen Bozhang reply Family Medicine
Hello: The letter mentions that your platelet counts from the past few years of health check-ups have been within the normal range (normal platelet count is 150,000-400,000/μL).
Additionally, small subcutaneous hemorrhages are usually caused by bleeding from the skin's microvasculature for unknown reasons.
If your petechiae are prominent or if you experience spontaneous bruising, you should visit a general internal medicine clinic for further evaluation to determine if there is an issue with platelet function or coagulation factors.
If the red spots are very small, you can observe them for a few days.
Reply Date: 2013/01/18
More Info
Subcutaneous hemorrhage, often presenting as small red or purple spots on the skin, can be concerning for various reasons. The sudden appearance of such spots, particularly after activities like a massage, can be attributed to several factors, including trauma, underlying vascular issues, or even certain dietary choices. In your case, the dark red or coffee-colored spots on your left arm could be related to the massage you received, which may have caused minor trauma to the blood vessels in the skin, leading to localized bleeding.
When considering the potential causes of subcutaneous hemorrhage, it is essential to evaluate the following:
1. Trauma or Injury: As you mentioned, the massage could have inadvertently caused bruising. Even gentle pressure can lead to small blood vessels breaking, especially if the skin is sensitive or if there is a history of bruising easily.
2. Vascular Health: Conditions affecting the blood vessels, such as vasculitis or other vascular disorders, can lead to spontaneous bleeding. If you have a history of vascular issues or if the spots appear without any clear cause, further investigation may be warranted.
3. Blood Disorders: While your platelet count appears to be within normal limits (240,000), it is crucial to consider other blood disorders that might not be reflected solely by platelet count. Conditions such as thrombocytopenia, hemophilia, or other clotting disorders can lead to increased bleeding tendencies. If you have a family history of bleeding disorders or if you experience other symptoms like excessive bruising or prolonged bleeding from cuts, it would be prudent to consult a hematologist.
4. Medications and Supplements: Certain medications, including blood thinners (like aspirin or warfarin), can increase the risk of bleeding. Additionally, supplements such as fish oil or ginkgo biloba can also affect bleeding risk. If you are taking any medications or supplements, it is essential to review them with your healthcare provider.
5. Environmental Factors: Dry weather can exacerbate nasal bleeding, especially if you have a deviated septum, as you mentioned. The dryness can lead to cracking of the nasal mucosa, resulting in minor bleeding. Keeping the nasal passages moist with saline sprays or humidifiers can help mitigate this issue.
6. Oral Health: The bleeding from your gums when brushing your teeth could indicate gingivitis or periodontal disease, especially if food particles are getting trapped around your braces. Maintaining good oral hygiene and regular dental check-ups are crucial to prevent gum disease, which can lead to bleeding.
Given your symptoms and concerns, it is advisable to monitor the situation closely. If the subcutaneous hemorrhage persists, worsens, or if you develop additional symptoms such as significant bruising, prolonged bleeding, or systemic symptoms (like fever or fatigue), it would be wise to seek medical attention. A thorough evaluation by a healthcare provider, including a detailed history and possibly further blood tests, can help determine if there is an underlying condition that needs to be addressed.
In summary, while the appearance of subcutaneous hemorrhage can often be benign and related to minor trauma, it is essential to remain vigilant and consult with a healthcare professional if you have concerns about bleeding disorders or if the symptoms persist.
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