The name derives from the observation that the painful ecchymoses could be reproduced if the patient's own red cells were injected subcutaneously. Management with corticosteroids, antihistamines, chloroquine, low-allergen diets, and psychotherapy has been ineffective. Similar damage can be caused by emboli that arise from infected heart valves. Fat embolism may complicate fractures of the long bones and pelvis. The syndrome consists of fever, confusion, and petechiae or purpura, or both, over the neck, chest, face, and axillae.
Cholesterol embolism can also cause petechiae, usually over the lower extremities.
It typically occurs in a patient with severe atherosclerosis who has recently undergone an invasive procedure involving the abdominal aorta or renal arteries. Biopsy of the purpura shows cholesterol crystals when an appropriate stain is used.