What Is Aplastic Anemia Rash?

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Anemia is a condition in which a person has a low red blood cell count. Some people with aplastic anemia, a very rare form of the condition, will develop skin issues that appear as a rash. "Anemia rash" is not an official term, so your healthcare provider may use the words "petechiae" or "purpura" to refer to your rash, depending on its size and characteristics.

Learn more about skin manifestations of aplastic anemia in this article.

Aplastic Anemia

There are multiple types of anemia.

Aplastic anemia occurs when there is an issue in your bone marrow, and not enough red and white blood cells and platelets are produced. It is a very rare disorder.

A lack of red blood cells, white blood cells, and platelets (pancytopenia) can cause symptoms such as:

  • Fatigue
  • Pallor (pale skin)
  • Dizziness
  • Excessive bleeding and bruising
  • Petechiae and purpura
  • Frequent infections

Platelets, in particular, are the blood cells responsible for clotting. When we get injured, even if it is a small injury to a blood vessel wall, clotting is what stops the bleeding and begins the healing process.

Without enough platelets, a person may bleed excessively and be susceptible to bruising. This is what leads to the skin abnormalities sometimes referred to as "anemia rash." It often presents like lots of red or purple pinpricks, and sometimes larger sores, on your legs or arms.


It is common to mistake petechiae for a rash, but they are actually due to a bleeding abnormality. They occur when tiny blood vessels break and hemorrhage (bleed) into the dermis layer of the skin.

Petechiae will present as the following:

  • Red, purple, or brown pinprick dots that are non-blanching (do not blend into the color of the skin when pressure is applied)
  • Flat on the skin (not raised)
  • Not itchy
  • Measuring less than 2 millimeters
  • Most commonly appearing on the legs, arms, buttocks, or stomach

In the context of aplastic anemia, petechiae occur due to low platelet counts, meaning the body is not clotting correctly and the tiny blood vessels are at a higher risk of breaking and bleeding into the skin.

In addition to aplastic anemia, petechiae can also be caused by trauma, straining, and certain infections, so it's important to see a healthcare provider to be correctly diagnosed.

This photo contains content that some people may find graphic or disturbing.

A petichae on a foot

Reproduced with permission from ©DermNet New Zealand and © Dr Lawrence Meyerson www.dermnetnz.org 2023.


Purpura are larger than petechiae, and often more purple than red. Similar to petechiae, they are a result of bruising that's caused by bleeding under the skin.

Purpura measure 4–10 millimeters. If the spot is larger than 10 millimeters, it is labeled as ecchymoses.

Also similar to petechiae, purpura can be the result of a low platelet count or poor clotting ability in those with aplastic anemia. However, there are other causes of purpura, too, so consult with your healthcare provider for a diagnosis.

This photo contains content that some people may find graphic or disturbing.

Purpura located on the ankle and foot

Reproduced with permission from ©DermNet New Zealand and © Raimo Suhonen www.dermnetnz.org 2023.


Petechiae and purpura can be resolved by treating the underlying condition. When they occur as a result of aplastic anemia, your healthcare provider will focus on treating your aplastic anemia to increase your platelet count.

Treatments for aplastic anemia can include:


While there is technically no official term as "anemia rash," sometimes people can get what looks like a rash as a result of bleeding abnormalities that are due to aplastic anemia. These are called petechiae and purpura, which appear as tiny red or purple pinpricks on the skin. They can be resolved by treating their underlying cause, aplastic anemia.

A Word From Verywell

While not very common, developing skin manifestations from aplastic anemia can occur. These can be unpleasant and uncomfortable, especially if they cause itching. Treating the underlying cause of the anemia can usually help alleviate the skin issues. Contact your healthcare provider if you experience skin issues as a result of your anemia.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. National Library of Medicine. Aplastic anemia.

  2. National Organization for Rare Disorders. Acquired aplastic anemia.

  3. Cleveland Clinic. Petechiae.

  4. Fairview Patient Education. Petichiae (child).

  5. National Heart Lung and Blood Institute. Thrombotic thrombocytopenic purpura.
  6. MedlinePlus. Purpura.

By Sarah Bence
Sarah Bence, OTR/L, is an occupational therapist and freelance writer. She specializes in a variety of health topics including mental health, dementia, celiac disease, and endometriosis.