1/11. Petechiae of the baby's skin as differentiation symptom of infanticide versus SIDS.The successive killing of three siblings by their biological mother at two-year intervals is described. The children were 367 days, 75 days and 3 years old. Although sudden infant death syndrome (SIDS) or interstitial pneumonia could not be ruled out as the cause of death in the two younger children, who were killed first, the third child exhibited discrete signs of violence in the mouth and throat area which were interpreted as proof of infanticide. All three children had petechiae of the skin of the face and throat, the upper thorax, the shoulders and the mucous membranes of the mouth. None of the children exhibited signs of a disease-related hemorrhagic tendency. After the mother was convicted of murdering the three-year-old boy by smothering in combination with compression of the thorax, she confessed to having killed the other two children in a similar manner. In the absence of hemostatic disease, the presence of petechiae of the skin extending over the entire drainage area of the Vena cava superior can be regarded as evidence of an increase in pressure in the thoracic cavity secondary to obstruction of the airways with simultaneous chest compression.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/11. Powerlifter's purpura: a valsalva-associated phenomenon.The causes of purpura can be classified into intravascular, vascular, and extravascular mechanisms. We describe a case of cervicofacial purpura in a powerlifter attributed to the accompanying Valsalva-associated increased arterial pressure. Powerlifting should be added to the list of activities that may cause purpura.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/11. Palpable purpura and a visible sock line.A 21-year-old woman came to the clinic, frightened by a painful purpuric rash on her lower extremities. The lesions appeared suddenly 3 days before, with no prior similar episodes. The pain, and some swelling that happened when she stood, had finally driven her to take some time off from her job and seek medical advice. She was diagnosed with a case of pharyngitis earlier that week; due to multiple drug allergies, she was prescribed a course of clindamycin. She had not experienced any nausea or vomiting, fever, abdominal cramping, or gross hematuria. On examination, the patient was friendly and good-humored, although she was concerned about her rash and visibly uncomfortable. She was walking with the aid of a borrowed cane, but her lesions were no longer tender to palpation. The rash consisted mainly of purpuric papules almost entirely limited to her legs, although some isolated lesions were on her back as well. The papules were concentrated around her distal lower extremities, with a clear line of lesions encircling her calves bilaterally where her knee-high socks had applied pressure for the last 2 days. Mild edema was noted, but the rest of her physical exam was normal. By dipstick, the patient had blood in her urine but no protein. What is the diagnosis? What is the treatment for this condition?- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/11. Psychogenic purpura: a most distressing case.A case of psychogenic purpura is likely to be unforgettable for everyone concerned. The patient's bizarre and dramatic appearance can frighten both the patient and medical personnel unfamiliar with the condition, causing panic and intense demands for drastic, inappropriate remedies. Our second experience with this condition was such a memorable case. We stress how difficult it can be to withstand the pressures of colleagues, the patient, and his or her family, and how important it sometimes is to be resolute regarding the need for conservative management.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/11. Chronic vulvar purpura.We described a 56-year-old Japanese woman with a long-standing asymptomatic vulvar purpuric lesion. Histological studies revealed massive hemorrhage, deposition of hemosiderin and a moderate lymphohistiocytic infiltration. We speculate that chronic intrapelvic congestion with increased venous pressure possibly due to abdominal ptosis played an important role in the pathomechanism for this persistent purpuric lesion of the vulva.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/11. diagnosis of autoerythrocyte sensitization syndrome in the emergency department.Autoerythrocyte sensitization syndrome is characterized by sudden and spontaneous painful bruising and swelling occurring in young female patients with psychiatric disorders. This syndrome may present with such severe swelling of involved areas that aspiration or excision may be needed to relieve pressure. The presentation of this condition in the emergency department must be differentiated from more common coagulopathies. Differentiation from the self-mutilation disorder, which often presents to the ED, can be difficult. Although the pathogenesis is uncertain, purpuric lesions are reproduced by injections of washed red cell erythrocyte stroma, suggesting an autoimmune etiology. We describe a patient with recurrent bruising diagnosed in the ED who responded with classic inflammation to autologous injection of red blood cells.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/11. Resuscitation and petechiae.Petechiae can be important corroborative evidence of asphyxia, but are also seen in persons who have died of other means. It is not uncommon to encounter them in cases in which cardiopulmonary resuscitation has reestablished blood flow and pressure in small vessels already damaged by hypoxia resulting in the formation of petechiae. This report documents some representative cases.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/11. Recurrent idiopathic angioedema in the presence of increased capillary fragility: an unusual case presentation.A case of petechiae formation associated with recurrent idiopathic angioedema is presented. The mechanism for the petechial formation appears to be related to the underlying presence of increased capillary fragility in association with elevated venous pressure caused by angioedema. The persistence of the increased capillary fragility during the long, symptom-free intervals between acute episodes of angioedema suggests that the capillary fragility is unrelated to the pathologic process responsible for the angioedema.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/11. blood pressure monitor-induced petechiae and ecchymoses.A case is presented of a diabetic, hypertensive, female patient who suffers from a bleeding complication from application of an ambulatory blood pressure monitor. A recent literature search is referred to and practitioners are cautioned against this adverse reaction.- - - - - - - - - - ranking = 5keywords = pressure (Clic here for more details about this article) |
10/11. Cutaneous reaction to vasopressin.Vasopressin (Pitressin, 8-arginine vasopressin) is a potent vasoconstrictor of splanchnic arterioles. When administered by continuous intravenous infusion, it reduces portal blood flow and pressure and is used in the management of bleeding esophageal varices. We describe a purpuric and necrotic cutaneous reaction to vasopressin that occurred at locations distant from intravenous catheter sites, and we review previous reports of similar reactions.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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