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Having petechiae, normal blood work and CBC. Can I have petechiae and be completely healthy?

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I have been having petechiae since October 2011. They are off and on and spread through out my whole body, no one particular place that they show. I see them on my legs, calves, torso, and upper breast area. I have had a cbc drawn up twice with normal blood work. Ive seen three doctors and I still am not giving an answer to why I am having petechiae, ive also seen a dermatologist who still didnt seem concerned, however, Im concerned and cant really put my mind to ease because I wouldn't be having these 'red dots' if something wasn't wrong. Can you have petechiae and be completely healthy?? or is there something else going on that should be investigated more. They do not last for more then two days and go away as quickly as the come. If i scratch them they go away with in a few hours. My derm did give me a more advanced blood work paper to get more blood drawn but she didnt really think it was necessary( im holding off on that) she also said they would do a biopsy to look for inflammation but thinks they would find little to no inflammation at all. Im really not left with much but to worry at this point.
Posted Sun, 6 May 2012 in Blood Disorders
Answered by Dr. Robert Galamaga 1 hour later
Hello and thank you for submitting your question.

Your question is a good one and I will work on providing you with some good information and recommendations regarding the symptoms you are experiencing.

first of all I have to question whether or not you're truly experiencing petechiae. In order to clarify I want to make sure that your understanding of petechiae is that these are small areas of bleeding in tiny capillaries which are just under the skin. We sometimes see this in the field of hematology with patients who have very low platelet counts or inpatients who have issues with normal blood coagulation. It is not common for these areas to come and go very rapidly. They tend to resolve over a couple of days.

I'm wondering if it is possible for you to send me a photo of a representative area that you are talking about. You could send this in electronic format to my attention at the following email address: YYYY@YYYY . I would then be able to review the image to render an opinion as far as what might be the underlying cause.

If there is some type of inflammatory component your doctor can do some blood tests in order to check to see if there is some degree of background inflammation. These tests include sedimentation rate as well as CRP. In addition I would be interested to know if you're coagulation factors have been evaluated. These are checked with basic blood tests that we are calling PT and PTT.

I would also be interested to know the family history. Do your parents or your siblings have any chronic medical problems. Is there any type of disorder which seems to run in the family even in aunts or uncles?

I can appreciate that what you're dealing with is providing you with a great deal of anxiety. I will do my best to inform you as much as possible. I again thank you for submitting your question and I look forward to hearing back from you soon so we can provide further information and recommendations.


Dr. Robert
Above answer was peer-reviewed by
Follow-up: Having petechiae, normal blood work and CBC. Can I have petechiae and be completely healthy? 39 minutes later
Are the sedimentation rates and CRP's tested in a regular CBC draw? If so then those came back normal. I haven't had a PT test or a PTT test done maybe I should consider doing so. My mom who is a RN says that there is no medical history of blood disorders in our family. All 3 of the doctors would not confirm them to be petechiae. One ER doctor said it looked to be vasculitis but when my blood results came back normal he said it wasnt. Im working on sending pictures to the email you provided shortly. I do think they are petechiae, they dont blanch and look red like blood.
Answered by Dr. Robert Galamaga 11 hours later
Hello and thank you for your follow-up question.

Regarding the Complete Blood Counts (CBC), this does not contain inflammatory markers such as sedimentation rate or C-Reactive Protein (CRP). These would be test that your doctor needs to request independently. Hey, vasculitis can also cause these types of symptoms as well and that is certainly a valid consideration.

In addition I would like you to think about your diet and any types of supplements that you have been taking recently. If there is anything out of the ordinary please let me know. In addition it is certainly important to rule out pregnancy. Please let me know if you have any issues with your period Or if you are late on your period.

If you have copies of your blood tests I would appreciate it if you could forward those to me as well to review.

Again I thank you for submitting your question and I look forward to trying to help you figure out what is going on along with your doctors.


Dr. Robert
Above answer was peer-reviewed by
Follow-up: Having petechiae, normal blood work and CBC. Can I have petechiae and be completely healthy? 1 hour later
My periods are normal and always right on track. My diet is the same its always been, I work out and eat fairly well. As of right now I currently have none that I can see, but that may change tomorrow and bam then I have them. Were you able to see the pictures I uploaded? what do they look like to you? I guess I will look into having more blood drawn. Can you have petechiae with no known causes??
Answered by Dr. Robert Galamaga 11 hours later

Thank you for the follow up question.

I reviewed the pictures that you uploaded. Thank you for doing that. Honestly these do not look like petechiae. These look more like something which could be a mild degree of infection. There are certain viruses and sometimes bacteria that can cause skin changes like the ones I see in your picture.

Sometimes these can be more prominent with individuals who exercise regularly. Exercise causes some degree of friction on the surface of the skin in areas where clothing rubs on the skin during exercise. In addition with excessive amounts of sweating there can be some irritation of the pores of the skin as well.

What I seen your picture does not look worrisome at all and it does not look like its any type of harbinger of any systemic problem.

Again the fact that these areas also resolved very quickly is more reassuring.

I understand this is a truly unusual problem in your case; but this does not look like it is a reflection of some degree of hematological disorder. I agree with the possibility of doing a biopsy to confirm what exactly is going on but this will have to be timed carefully with your dermatologist. The pathologist can then review the skin under the microscope to determine if there is anything other than a mild degree of inflammation going on.

Thank you again for sharing your concern with me. I hope you have found my responses to be helpful and informative. If you have any additional concerns please let me know.


Dr. Robert
Above answer was peer-reviewed by
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