Disorders of the Vascular Endothelium
  • Usually seen as easy bruising, petechiae and excess or spontaneous bleeding from mucous membranes
  • Platelet counts / coagulation screening tests are usually normal
  • Seen as Acquired and Hereditary forms

Hereditary Telangiectasia

  • Rare
  • Autosomal dominant
  • Spontaneous bleeding can lead to iron deficiency
  • Dilated blood vessels (usually capillaries) associated with abnormal collagen formation leading to bleeding
  • Heterozygous form
  • Homozygous form (fatal):
      Gastrointestinal tract
      Soles of the feet
      Mucous membranes
      Lips
      Tongue
      Palms
  • Blood blisters in the mild (heterozygous) forms and bleeding from these areas in the more severe cases

Acquired

  • The subendothelial connective tissue is diminished leading to easy bruising

  • Senile purpura

      Spontaneous ecchymoses Extremities suffer the most Due to loss of basement membrane/collagen with age Small blood vessels burst and form bruises because of this lack of support
 

Purpura

      Produce ecchymoses Allergic: Immunological reaction causing vessel wall damage Drug induced: Simplex: Usually in young women manifesting as easy bruising
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