What is the differential diagnosis for a petechial rash on the leg?

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Last updated: April 27, 2025 • View editorial policy

Differential Diagnosis for Petechial Rash on the Leg

Single Most Likely Diagnosis

  • Idiopathic Thrombocytopenic Purpura (ITP): This condition is characterized by low platelet count, leading to petechiae, purpura, and bruising. It is a common cause of petechial rash, especially in children and young adults.

Other Likely Diagnoses

  • Vasculitis: Conditions like leukocytoclastic vasculitis can cause petechial rashes due to inflammation of small blood vessels.
  • Infection: Bacterial, viral, or fungal infections (e.g., meningococcemia, Rocky Mountain spotted fever) can lead to petechial rashes.
  • Medication-induced thrombocytopenia: Certain medications can cause a decrease in platelet count, resulting in petechiae.
  • Trauma: Physical injury can cause petechial rashes, especially if there is significant bruising or bleeding under the skin.

Do Not Miss Diagnoses

  • Meningococcemia: A life-threatening infection that can cause petechial rash, especially in children and young adults. Prompt recognition and treatment are crucial.
  • Disseminated Intravascular Coagulation (DIC): A condition characterized by widespread clotting and bleeding, which can cause petechial rash, among other symptoms.
  • Thrombotic Thrombocytopenic Purpura (TTP): A rare blood disorder that can cause petechial rash, along with other symptoms like fever, weakness, and neurological abnormalities.

Rare Diagnoses

  • Henoch-Schönlein Purpura (HSP): A form of vasculitis that can cause petechial rash, abdominal pain, and joint pain, typically in children.
  • Ehlers-Danlos Syndrome: A genetic disorder that can cause fragile blood vessels, leading to petechial rashes and easy bruising.
  • Scurvy: A condition caused by vitamin C deficiency, which can lead to petechial rash, among other symptoms like fatigue and joint pain.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.