Pictures?!?

Hello all, when my hem department sees my sons petichia (sp?) and bruises they always say oh thats nothing you should see some of our patients! Mind you with the small dots he has/had he still has some bleeding so for him I guess its bad enough. I know everyone reacts differently....but are there some photos out there of other people's petichia? I don't want to see the people just the spots...Im not trying to be morbid or sick just would like to compare.

Here are two:

Here is a bruise. This one is pretty bad, but they can look like this in the worst case scenario. I've had one pretty close to this.

This stuff is scary and really puts what I've dealt with in proper perspective.

Wow, I think I'm lucky compared to those pics, I don't think I have ever had quite that many on my legs and feet before.

:ohmy: O.M.G.
I've not had anything like that. Whew......
maybe that dark, but not that many, or that big!

Here are some pictures from when I was first diagnosed. Petechia on my feet and lips were my first symptoms - and then the bruising came! My count was down to 1,000 at this time. I'm doing fine now - last platelet count was 278,000! Amy

Sandy,
Do you know how low their platelets were with this much bruising and petechia? This seems like a severe case?? The one with the dark bruise looks like she might have fell to get such a large bruise.

Dee Dee

I was wondering the same thing as DeeDee.

Are these things that we should be waiting for BEFORE we decide to go to a hospital or are these examples of situations that are far past jut considering going to the ER?

We seem to vary a lot in how much we bruise and so forth. For myself, it would depend on what I know about my counts and my symptoms. I'll have bruising when my count is in safe zones, 30-50. Once my dog accidentally bit me on the thigh, we were playing and she missed the bone and got me, and I had an awful huge bruise that lasted a long time. Normally I don't have any visible signs when my counts are very low, I might feel awful but I don't have blisters or petechia even when I was below 10. That said, if I had anything that looked like the pictures I'd get myself a count and let my hema know.
Erica

Yeah symptoms can be weird. I've had tons (around 24) bruises when I was around 75k. And then I have been surprised on weeks where there is almost no bruising but my counts are in the 40s or lower. I'm at my lowest (24k) this week and my body has looked way worst at much higher counts.

Those pictures do not paint a great picture. Unfortunately my daughter (who is 9-1/2 now but was diagnosed 6 years ago) was a victim of the same issues. When she was low her body was covered head to toe with Bruising and Petechiae. She was also a thumb sucker so she would have a mouth full of the quarter size blood blisters. You absolutely would want to get checked if the marks are looking bad. The debate with a lot of people is treating the numbers or the symptoms. The symptoms are the bad bruising, etc and bleeding. My understanding as to why some people mark worse than others has to do with the strength of their vascular system. We had a time where our doctor did not think that prednisone was necessarily helping the platelet count, but did think it was strengthening her vascular system thus minimizing the chances of bleeding. At my first PDSA conference 5-1/2 years ago I met some parents whose kids also marked really bad but than as they got older it subsided a bit. The only explanation (non medical) I got was that their body learns to deal with it better. Over the last couple years we have experienced the same thing. We used to know, by the marks on her body, what her count would be. Now, we will go in for a count thinking all is good, than find out that she is very low. Once again, this condition likes to take sharp and new turns so we always have to be on our toes.

I hope this helps,

JJ

I spoke with my Hema last week and he said this: When talking about acute vs chronic ITP there is an interesting note- People with chronic ITP have 'better' platelets. Meaning that they function better than someone who has acute ITP or thrombocytopenia (not sure if there is a difference between the two) when the numbers are low. Someone with Acute ITP may show signs of bleeding at 50k, while someone with Chronic ITP may not show signs of bleeding until 10k or less. (Totally made those numbers up, he didn't say those specifically) . Jaycharness, I was just thinking of this when you said that our bodies "learn to deal with it better."

The bruise that I had that looked like that came when my counts were 3-8. I did not bump myself at all - it was a spontaneous bruise. I was new to ITP and my doctor was treating me once a week with Win-Rho which was not working. Bad plan.

I've also had petechiae and purpura like that on my chest. I thought my counts were really low so I went in; they were 50. I have no explanation as to why the purpura was so nasty. It hasn't happened since.

Yes, those are worst case scenarios, but you asked! A few petechiae or small yellow bruises are really minimal compared to what it could be.

OMG!!! Thank you all for the photos...I will try to post soon a pic of my son's "peekies" as we call them. I think you'll all laugh at me and wonder why Im so freaked out because they are only on his lower legs and arms...a few here and there on his torso. The bruises that he gets are usually ones that he got bonking his legs playing, and they don't go away, they just get darker when his counts drop. The new ones show up a flourescent blue. The petechiae are small and sometimes even at a 2 you'd need a flashlight to see them. It seems lately when his counts drop he's getting more and more and darker ones. Not sure why that is. When he was first diagnosed he was at a 3 and you could barely see them, now they are way more and darker. He had a nasty bruise on his arm from bloodwork and then they stuck the IV right in the middle of it, and it of course got worse. It took weeks to go away...but nothing like in the photos. Wierd how everyone reacts differently. No wonder the docs don't seem all that concerned until they actually do a count because Josh seems to like 2's and 3's.
Our hem doc actually told us that pred will protect him from bleeding!?!? Dunno....My brain hurts, its a bad day today.

Yes, it's like Jay said - Prednisone promotes vessel integrity. The thing is, it also thins the skin which can make bruising worse, so it's a double edged sword.