Purpura on the feet

It is quite common for purpura to appear on the feet, especially when some people do not pay attention to their personal hygiene, which makes this situation more and more likely to occur. Some patients suffer from genetic factors, so the treatment may be relatively more difficult. In this case, relevant treatment needs to be carried out first.

1. Hereditary hemorrhagic telangiectasia

There is currently no cure for hereditary hemorrhagic telangiectasia, and treatment is mainly symptomatic.

The treatment method is mainly divided into the following steps:

1. Stop bleeding

For superficial bleeding, compression is the main method of hemostasis. For internal bleeding, consider using carbaclot (Anloxue) to help small blood vessels contract, and using vasopressin to reduce the pressure in internal visceral blood vessels.

2. Blood transfusion

It is only used for those who have lost a lot of blood, but it should not be used in excess to avoid high blood pressure that makes it difficult to stop bleeding.

3. Iron supplement

Suitable for patients with chronic hemorrhagic anemia.

4. Others

Hepatic artery embolization can be used to treat hepatic arteriovenous fistula, and beta-blockers can improve the hyperdynamic circulation state, reduce hepatic blood flow, and reduce shunt volume.

However, because pulmonary arteriovenous fistula is dangerous, even if there are no symptoms, a thorough examination should be conducted to check for this problem so that preventive embolization therapy can be performed. Before embolization of the pulmonary arteriovenous fistula has been completed, any surgical or dental work should be supplemented with antibiotic prophylaxis to avoid brain abscess. For accessible telangiectatic lesions (such as the skin, or endoscopically inserted into the nose or digestive tract), direct compression, laser enucleation, surgical suturing, resection of the lesion, or use of local hemostatics can be used. Arteriovenous fistulas can be surgically resected or embolized.

Those who need repeated blood transfusions should pay attention to preventing hepatitis B. Most patients need to take iron supplements for a long time to replenish the iron lost due to repeated mucosal bleeding, and some patients need iron supplements outside the digestive tract. Hepatic artery embolization can be used to treat hepatic arteriovenous fistula. β-blockers can improve the hyperdynamic circulatory state, reduce hepatic blood flow, and reduce shunt volume.

(ii) Allergic purpura

1. Eliminate pathogenic factors

Prevent and treat infections, clear local lesions (such as tonsillitis, etc.), expel intestinal parasites, avoid foods and drugs that may cause allergies, etc.

2. General treatment

(1) Antihistamines

Such as promethazine hydrochloride, chlorpheniramine (Chlorpheniramine), astemizole (Astemizole), deschlorohydroxyzine (Clematinib), terfenadine (Mindy), etc., can also be injected intravenously with calcium gluconate.

(2) Drugs that improve vascular permeability

Vitamin C, troxerutin, etc.

3. Glucocorticoids

Glucocorticoids have the effects of inhibiting antigen-antibody reaction, reducing inflammatory exudation, and improving vascular permeability. Therefore, they are effective in reducing bleeding and alleviating symptoms. They have certain effects on joint symptoms and abdominal pain in some patients, but have no obvious effect on skin purpura and nephritis.

4. Symptomatic treatment

For patients with severe abdominal pain, atropine or scopolamine can be taken orally or injected subcutaneously; for joint pain, analgesics can be used as appropriate; for severe vomiting, antiemetics can be used; for patients with vomiting blood and bloody stools, omeprazole and other treatments can be used.