Palpable Purpura


Palpable Purpura survival.

This is a distillation of what I experience with palpable purpura. Others in Alliance for Cryo Support groups have had the same experience and so I thought you might find this useful.

Palpable Purpura is a kind of skin lesion common to small and medium vessel vasculitis.  Palpable Purpura is blood-filled lesions which are raised, and resemble blood-filled blisters, typically from tiny up to about a centimeter (about the size of a dime) in diameter. You can push on one with you finger and it will flatten out, and will not blanch (will not turn white) if the cause is vasculitis.  These lesion form rapidly (in a few minutes), and when active they can hurt much like a bee sting. Sometimes one only gets a few lesions, but at other times they can be numerous and the pain can become quite severe. The lesions can grow in size daily, and lesions which are close together may merge to form bigger lesions. The big risk here is that a large area of skin can die quickly , leading to ulcers, and infection and a host of other problems. This can be very bad.

The lesions are typically more active at night and it is not unusual to wake in the morning and find that your feet are covered with new lesions which formed while you slept. In the daytime, they may be less active and will be less full in appearance.  These lesions will continue to form until the vascultis remits. Once they begin to heal, it often takes about a week to ten days for the blisters to drain, and form scabs over the lesions which will gradually heal over a period of weeks, or months.

Here are some things you can do to make things a little more bearable:

  1. Reduce pressure on your skin in your feet, buttocks, thighs and legs. Get comfortable, and rest. Wear loose, comfortable clothing. Your skin is more prone to forming new lesions right now, and any pressure or abrasion to the skin can encourage new lesions to form. So, kick your shoes off , prop your feet up and take it easy.
  2. I found that taking Advil really helped reduce inflammation quite a lot. But at the same time, the process that was causing the lesions did not stop until my vascultis was treated well enough to force it to remit.
  3. For years, some doctors have advised taking an antihistamine ,particularly in the evening as a treatment for Palpable Purpura. The fact is that there is no medical basis for doing so, and there is no medical evidence that it ever worked for anyone. I know that it never worked for me….
  4. Watch out for signs of infection. If you are on immunosuppression therapy, the last thing you want to have happen is to pick up an opportunistic infection. Keep the lesions clean and dry, and take a good look at them daily to be sure they are healing. If you see signs of infection, see your doctor right away.