RT Book, Section A1 Friedman, Marla J. A1 Mendoza, Carolina A2 Tenenbein, Milton A2 Macias, Charles G. A2 Sharieff, Ghazala Q. A2 Yamamoto, Loren G. A2 Schafermeyer, Robert SR Print(0) ID 1155428408 T1 Petechiae and Purpura T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 5e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259860751 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1155428408 RD 2024/03/29 AB Purpura may be a sign of an underlying life-threatening illness that requires immediate attention.Petechiae above the nipple line with a history of cough or vomiting may be benign and caused by increased venous pressure.Purpura is present in almost all patients with Henoch–Schönlein purpura (HSP), but it may not always be the presenting sign. This can cause a delay in the diagnosis.Consider idiopathic thrombocytopenic purpura (ITP) in a nontoxic-appearing child with absence of splenomegaly and a normal hemoglobin and white blood cell count.Child abuse should be suspected if bruising occurs in non-bony prominences or in areas not normally subjected to injury, or if the history is not consistent with the physical findings.