Petechiae or not?

[napereira]

Hello,

I am 30 year old male.  A few weeks ago I went to the ER because I had little red dots on my legs, feet and back.  They looked like petechiae.  In the past I had platelets that were on the lower side, but docs never thought it was a problem.  The ER doctor said he needed to run a cbc with platelet and some clotting tests PPT, and PT and something else I forget.  Anyway, my platelet count came back normal at 184000.  The rest of my cbc was fine, all normal - and my clotting tests were normal.  I am an admitted hypochondriac and have been worried about leukemia or some other disease.  I know  petechiae can be a symptom.  I haven't been able to sleep and its interfering with my life. The doctor said that the reason some leukemia patients get petechiae is because their platelets are low, since mine are not low, they're normal, there's no connection.  This sounds reasonable, but I cannot seem to stop convincing myself I have some awful disease.  He said it could be from an allergic reaction to medication or some other benign cause. They have been fading slowly, and I am much better however I still see some appear and disappear.  Doctor, can I be assured this is not related to leukemia or blood disease?  Did the doctor miss something?  I'm VERY worried.. thank you.

[Kevin Pho, MD]

If the CBC and clotting tests were normal, it makes it less likely that a blood disease or leukemia is present.

Regarding the spots on the legs - I can't tell whether they are petichiae or not without seeing them.  Typically petichiae don't blanche when pressure put on the lesion.

Here is a picture of sample petechiae:
http://medic.med.uth.tmc.edu/edprog/Path/infdis/infect59.jpg

I would discuss your concerns with your personal physician or in consultation with a dermatologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[Arethereanynicknamesnotinuse?]

I am a 36-year old female with petechiae, and I have also been worried about leukemia, although my blood tests came out fine.  I started on Lexapro about two months ago, and shortly thereafter noticed the petechaie on my calves (it took me a little while to realize it wasn't razor burn).  I assumed it was an allergic reaction, so I spoke with my psychiatrist and she took me off the Lexapro (I was on it for almost exactly a month) and put me on Cymbalta.  The petechiae went away when I was on my "introductory" dose of 10mg/day, but once I graduated to 20mg, the petechiae came back.  I went to see my internist and he took me off the Cymbalta.  It took about two weeks, but the petechiae went away again, so my internist put me on Wellbutrin.  After three days, the petechiae are back.  I'm pretty much at my wits end, and now he's (my internist) beginning to wonder if it isn't drug-related at all.  Apparently, Wellbutrin is totally different (chemically speaking) than Lexapro and Cymbalta, so he's puzzled about why the petechaie returned when I started the Wellbutrin.  Has anyone ever heard of this, or experienced the reaction with multiple antidepressants?

[sounder]

I went to the dermatologist today and asked that she examine a "rash" on both shins.  I thought it was an allergic reaction.
She suggested a biopsy and a blood test.  I am glad to have found your site.