Facial purpura

Objectives: Patients with facial purpura can have acute and dramatic illnes ses. For this reason, the clinician must be aware of certain diagnoses that can present as facial purpura and know how to initiate treatment efficient ly. According to our review of the literature, no paradigm currently exists for the diagnosis and management of facial purpura. Our goal is to develop a schema for the identification and management of facial purpura. Study De sign: Case series. Methods: A case series of five cases is presented follow ed by a systematic development of a differential diagnosis based on etiolog y of the lesion. Results: Facial purpura can be classified into conditions that are primarily or secondarily vasculitic, thrombocytopenic, neoplastic, infectious, toxic, and miscellaneous, which encompasses episodic reports t hat do not fit into the other categories. A paradigm to diagnose patients w ith facial purpura is developed based on clinical presentation and etiology . To demonstrate the utility of our algorithm, the five cases presented are re-examined using the algorithm. To our knowledge, this represents the fir st reported series of facial purpura in the modern. English literature. A f low chart based on our diagnostic paradigm is presented. Conclusion: Clinic ians caring for patients with facial purpura must recognize the acute condi tions that require emergent medical intervention. Once these diagnoses have been considered, the clinician can employ a systematic approach to the dia gnosis based on etiology. This study provides a useful reference for the ot olaryngologist when encountering a patient with facial purpura.