Conjunctival and periorbital petechiae presumed secondary to self-inflicted asphyxiation in a pediatric patient

Kaufman, Aaron R.; Oh, Daniel J.; Gliksberg, Ariel; Schmidt, Mary Lou; Mocan, Mehmet Cem

doi:10.1016/j.jcjo.2021.01.001

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…1,2 Concerning causes of periorbital petechiae include seizures and strangulation. 2,3 It is also import ant to consider the possibility of interpersonal violence as a cause of facial petechiae. A detailed medical and social history, along with physical examination, can help determine subsequent investigations.…”

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confidence: 99%

Periorbital petechiae after emesis in a young woman

Zhang¹,

Chen²,

Xu³

2023

CMAJ

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A 27-year-old woman presented to the dermatology clinic with a 1-day history of sudden-onset, painless, nonpruritic, periorbital rash. The patient had several episodes of intense vomiting related to alcohol intake 1 day before onset of the rash. She was previously healthy and had not taken medications around the time of rash onset. On examination, we observed nonpalpable petechiae (1-2 mm in diameter), involving both periorbital regions and cheeks, that did not blanch under direct pressure of a glass slide (Figure 1). The only laboratory investigation we ordered was a complete blood count, which showed a normal platelet count and mean platelet volume. We diagnosed petechiae induced by elevated intravascular pressure from her vomiting. The rash resolved after 1 week without any therapeutic intervention. On a phone follow-up 2 years later, she reported no recurrence of petechiae since her initial presentation.Cutaneous purpuric lesions are a result of extravasation of blood into the skin or subcutaneous tissue. Petechiae are small lesions that measure less than 2 mm in diameter. Lesions between 2 mm and 10 mm are purpura and become ecchymoses when they are more than 10 mm in diameter. 1 Periorbital petechiae are a clinical sign of elevated intravascular pressure induced by events such as severe vomiting, coughing, crying, infant delivery and the Valsalva manoeuvre. 1,2 Concerning causes of periorbital petechiae include seizures and strangulation. 2,3 It is also import ant to consider the possibility of interpersonal violence as a cause of facial petechiae. A detailed medical and social history, along with physical examination, can help determine subsequent investigations. Petechiae induced by elevated intravascular pressure and no other underlying medical condition usually resolve after 1-2 weeks and do not require further investigation or treatment.

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confidence: 99%

Periorbital petechiae after emesis in a young woman

Zhang¹,

Chen²,

Xu³

2023

CMAJ

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“…Les pétéchies périorbitaires sont un signe clinique d’une pression intravasculaire élevée, causée par des facteurs comme des vomissements intenses, la toux, les pleurs, l’accouchement ou la manœuvre de Valsalva 1 , 2 . Parmi les causes préoccupantes de pétéchies périorbitaires, il y a les convulsions et l’étranglement 2 , 3 . En présence de pétéchies faciales, il est important de soupçonner l’existence de violence interpersonnelle.…”

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Pétéchies périorbitaires après vomissements chez une jeune femme

Zhang¹,

Chen²,

Xu³

2023

CMAJ

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Conjunctival and periorbital petechiae presumed secondary to self-inflicted asphyxiation in a pediatric patient

Cited by 2 publications

References 10 publications

Periorbital petechiae after emesis in a young woman

Periorbital petechiae after emesis in a young woman

Pétéchies périorbitaires après vomissements chez une jeune femme

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