Post‐emesis periorbital purpura in hyperemesis gravidarum

Bhanja, Dibyendu Bikash; Mondal, Satarupa; Sil, Abheek; Das, Avijit; Panigrahi, Avik; Biswas, Surajit Kumar

doi:10.1111/ijd.15292

Cited by 3 publications

(5 citation statements)

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“…This represents a benign purpuric eruption owing to an abrupt increase in the venous and capillary pressure in the head and neck veins. Increased intra‐abdominal or intrathoracic pressure may occur due to cough, excessive crying, Valsalva maneuver, parturition, seizures, and vomiting, as stated by the authors 1 . Other causes of this increase of pressure may be constipation and exercise practice 5 …”

Section: Figurementioning

confidence: 93%

“…We read with interest the article by Bhanja et al 1 . describing a case of periorbital purpura due to hyperemesis gravidarum.…”

Section: Figurementioning

confidence: 99%

“…Dear Editor, We read with interest the article by Bhanja et al 1 describing a case of periorbital purpura due to hyperemesis gravidarum. We agree with the authors that anamnesis, physical examination, and a basic biochemical exploration, including coagulation profile, are the main tools for an initial approach in a patient with periorbital purpura.…”

Section: Reply To: Post-emesis Periorbital Purpura In Hyperemesis Gravidarummentioning

confidence: 99%

“…Increased intra-abdominal or intrathoracic pressure may occur due to cough, excessive crying, Valsalva maneuver, parturition, seizures, and vomiting, as stated by the authors. 1 Other causes of this increase of pressure may be constipation and exercise practice. access journals, up from 741 in the year 2000.…”

Section: Reply To: Post-emesis Periorbital Purpura In Hyperemesis Gravidarummentioning

confidence: 99%

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Reply to: post‐emesis periorbital purpura in hyperemesis gravidarum

2021

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Section: Figurementioning

confidence: 93%

“…We read with interest the article by Bhanja et al 1 . describing a case of periorbital purpura due to hyperemesis gravidarum.…”

Section: Figurementioning

confidence: 99%

Section: Reply To: Post-emesis Periorbital Purpura In Hyperemesis Gravidarummentioning

confidence: 99%

Section: Reply To: Post-emesis Periorbital Purpura In Hyperemesis Gravidarummentioning

confidence: 99%

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Reply to: post‐emesis periorbital purpura in hyperemesis gravidarum

2021

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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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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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