Is petechiae a clear sign of leukemia?

Seeing mysterious spots appear on your skin can be unsettling. Is it something scary or something harmless? 

Petechiae are small, flat and round spots that appear when tiny blood vessels break and leak a small amount of blood into the skin. They are usually red, purple or brown and about the size of a pinhead. 

Some people automatically think this is a symptom of leukemia, cancer of the blood. However, there may be other less severe reasons for these mysterious spots.

Dr. Demet Gokalp Yasar, a hematologist at Aurora BayCare Medical Center, answer some common questions people have about petechiae and their possible connection to leukemia: 

What causes petechiae? 

Petechiae can have many causes. Sometimes, they appear after minor injuries, coughing, or vomiting, which can put pressure on blood vessels. In other cases, petechiae may be a sign of a medical condition that affects how blood clots or platelets work. Other causes include: 

• Low platelet counts (thrombocytopenia) 
• Certain infections, especially if there’s also a fever 
• Reactions to medications 

What is the connection between petechiae and leukemia? 

The association is primarily due to low platelet count, which occurs when bone marrow is infiltrated by cancerous leukemic cells, leading to impaired platelet production.  

It’s important to recognize that while petechiae are a classic sign of leukemia, they’re not specific to this type of cancer and can be seen in other conditions causing thrombocytopenia or vascular fragility. 

Are petechiae serious? 

Petechiae can be harmless, especially if they appear in a small area and there are no other symptoms. However, they can sometimes be a sign of a more serious problem and require medical attention. This includes if petechiae:

• Appear suddenly and spread quickly 
• Are accompanied by fever, headache, stiff neck or confusion 
• Occur with other symptoms like easy bruising, bleeding gums or nosebleeds 
• Don’t go away or keep coming back 

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