What causes purpura on the skin of patients with advanced cancer?
Oct 31, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, purpuric skin lesions in patients with advanced cancer may be caused by prolonged bed rest and pressure, improper skin care, thrombocytopenia, coagulation disorders, or telangiectasia. Patients can choose appropriate interventions such as general supportive measures or medication based on their specific conditions. Daily skin care should be strengthened to maintain skin integrity and prevent trauma; skin condition should be monitored regularly.
In general, purpura (purple spots) on the skin of patients with advanced cancer may be caused by prolonged bed rest and pressure, improper skin care, thrombocytopenia, coagulation disorders, or telangiectasia. Patients can choose appropriate treatments such as general supportive care or medication based on their specific conditions. Detailed analysis is as follows:
1. Prolonged Bed Rest and Pressure
When patients remain in bed for extended periods, localized areas of skin are continuously compressed, leading to capillary rupture and bleeding, which results in purpura. It is recommended to assist the patient in turning over regularly—every two hours—and use soft mattresses and cushions under pressure-prone areas to prevent sustained pressure. Keep the skin clean and dry.
2. Improper Skin Care
The skin of late-stage cancer patients is often less elastic and fragile. Vigorous rubbing during cleaning or friction from clothing can easily damage blood vessels and cause purpura. Clean the skin gently with lukewarm water, wear loose, soft cotton clothing to minimize friction, and avoid using irritating cleansers.
3. Thrombocytopenia
Reduced production or excessive destruction of platelets in the body leads to impaired clotting function, making purpura more likely. Under medical supervision, patients may take medications such as aminopeptide tablets, Shengxue Xiaoban capsules, or caffeic acid tablets. In severe cases, platelet transfusions may be necessary. Diet should include iron-rich foods like red dates and spinach to support blood cell production.
4. Coagulation Disorders
Deficiency or dysfunction of clotting factors impairs blood's ability to coagulate, resulting in spontaneous purpura. Under a doctor’s guidance, treatments may include vitamin K1 injection, prothrombin complex concentrate, or fresh frozen plasma. Regular monitoring of coagulation parameters is essential, and strenuous activities that could lead to injury should be avoided.
5. Telangiectasia
Abnormal structure of blood vessel walls causes capillaries to become dilated and fragile, so even minor stimuli can cause them to rupture and bleed, forming purpura. Under medical advice, patients may take drugs such as rutin tablets, vitamin C tablets, or troxerutin tablets to strengthen blood vessel walls. Avoid trauma, collisions, or compression to the skin.
Daily care should emphasize proper skin maintenance to preserve skin integrity and prevent injuries. Regularly monitor skin condition, promptly record any new purpura, and inform the healthcare provider. Maintain a light, easily digestible diet rich in vitamins and protein to enhance skin resilience. Assist the patient with moderate physical activity to improve circulation and reduce the likelihood of developing purpura.
