in adults the eruption may appear upon the thighs (Fig. 55) and other portions of the body. In a child suffering from whooping cough I have seen the chest dotted with petechial spots. When the hemorrhage takes place in or around a hair follicle the lesions are apt to he elevated, and to this condition the term purpura papulosa has been applied.
In mild cases of purpura simplex the lesions usually appear suddenly without other symptoms, and gradually fade away
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Fig. 55.—Purpura.
in one or two weeks, unless a fresh outbreak occurs. In this event the bright-red color of the recent spots contrasts strongly with the dull livid hue of the older lesions.
In severe cases of purpura the eruption may be very abundant, and with the cutaneous lesions hemorrhage from various mucous surfaces may occur. The gums are usually swollen and bleed easily. Epistaxis is frequent and blood is often noted in the stools and urine. This form of the disease is called purpura hemorrhagica. It is characterized by marked
