Persistent Petechiae: Seeking Insights
For the past several weeks, my eight-year-old daughter has been developing a petechiae rash, which is appearing on her face, neck, chest, arms, and legs. While some spots disappear, new ones continuously emerge, creating a concerning cycle. We visited her pediatrician for further examination, where lab results indicated a PT of 28.8, an INR of 2.8, and an aPTT of 62, all of which suggested significant prolongation. After repeating the tests, thankfully, all the results returned to normal levels. We also screened for Von Willebrand disease, which came back negative, and her complete blood count (CBC) and platelet levels were within the normal range. Despite these findings, she continues to experience new outbreaks of petechiae, which is troubling for her, particularly since the rash is visible on her face and neck, causing her some embarrassment. Has anyone dealt with a similar situation or have any suggestions that I could discuss with her pediatrician? I will share some images in the comments for reference. Additionally, I wanted to mention that tests for cytomegalovirus and Epstein-Barr virus (EBV) also yielded negative results.
Answers (1)
8/9/2025, 7:10:55 AM
OpenHealth AI
It’s understandable to be concerned about your daughter’s persistent petechiae, especially given the visibility and the emotional impact it can have on her. Petechiae can be caused by various factors, and it’s good to hear that many preliminary tests have come back normal. Let’s focus on what we know and the next actionable steps to further address your concerns.
Key Points:
- Understanding Petechiae: These small red or purple spots on the skin can result from bleeding under the skin. They often appear when tiny blood vessels break, which can happen due to several reasons including infections, trauma, or even certain medical conditions.
- Monitoring Blood Tests: While the initial tests indicated some abnormalities, subsequent normal results along with a negative screening for von Willebrand disease are reassuring. This suggests that a bleeding disorder may not be driving the petechiae.
- Ongoing Symptoms: Since new petechiae are still appearing despite normal lab results, further discussions with her pediatrician may be necessary to explore alternative causes or management strategies.
Actionable Next Steps:
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Symptom Diary: Keep a diary tracking the appearance and distribution of the petechiae. Note any activities she was doing, recent illnesses, changes in diet, or other symptoms she may be experiencing. This information can provide valuable insights for her pediatrician.
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Discuss Potential Causes: When you next see her pediatrician, consider discussing:
- Allergic Reactions: Some children develop rashes from allergens or irritants.
- Vascular Responses: Conditions like capillary fragility can sometimes lead to sporadic petechiae.
- Environmental Factors: Recent changes in her environment (new pets, soaps, or foods) might be explored.
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Skin Care Routine: Ensure she has a gentle skincare routine to prevent any skin irritation. Avoid harsh soaps and moisturize her skin regularly.
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Emotional Support: Offer her emotional support by reminding her that this condition is not uncommon and that many children experience similar skin issues. Encourage her to express any feelings of embarrassment or frustration she may have.
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Consider Referrals: If the petechiae persists or if new symptoms arise, her pediatrician might consider referring you to a pediatric dermatologist or a hematologist for further evaluation.
By focusing on these steps, you can help gather more information for her pediatrician and also provide some relief and support for your daughter during this unsettling time. Remember that keeping communication open with her healthcare team is key to resolving this issue. If further symptoms arise, or if you simply need more clarity, don't hesitate to reach out again.
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