Tiny purple or red spots (petechiae) or bruises (purpura)

Rashes are usually not the first symptom to appear when a serious disease is present. Other symptoms will commonly occur before the rash. Early symptoms of a serious disease may include fever, a general feeling of illness, or a decreased level of activity.

There are two types of rashes that may be the first noticeable symptom of a serious illness:

• Petechial rash looks like tiny, flat, purple or red spots (petechiae). Many people have tiny, flat, red spots (hemangiomas) that are present all the time. If they have been present for a while, these spots are not a concern. New red or purple spots that develop rapidly over hours may indicate a serious bleeding disorder or severe infection that requires immediate medical treatment. Petechiae range from pinpoint-size to BB-size. The red spot of a petechia does not turn white (blanch) when you press on it. This type of rash is more likely to occur in children, but it can occur at any age.
• Purpura is sudden, severe bruising that may be localized, regional, or widespread, and occurs without an injury. It is usually caused by bleeding disorders, vasculitis, or a severe infection. Purpura may come on suddenly over hours or gradually over days. This bruising is spontaneous and is not related to injury or trauma. There may be other symptoms as well, such as fever or a decreased level of activity. Purpura differs from normal bruising caused by bumping into objects or falling; purpura causes many more bruises with no clear cause for the bruises. Purpura is more likely to occur in adults, but it can occur at any age.

Nonprescription and prescription medications may also cause abnormal bruising or bleeding. If you have noticed abnormal bleeding after starting a new medication, particularly if you take several medications, call your health professional.