A petechia () is a small red or purple spot (≤4 mm in diameter) that can appear on the skin, conjunctiva, retina, and mucous membranes which is caused by haemorrhage of capillaries. The word is derived from Italian , 'freckle,' of obscure origin. It refers to one of the three descriptive types of hematoma differentiated by size, the other two being ecchymosis (>1cm in diameter) and purpura (4-10mm in diameter). The term is always used in the plural (petechiae), since a single petechia is seldom noticed or significant. Causes Physical trauma The most common cause of petechiae is through physical trauma such as a hard bout of coughing, holding breath, vomiting, or crying, which can result in facial petechiae, especially around the eyes. Such instances are harmless and usually disappear within a few days. Constriction, asphyxiation – petechiae, especially in the eyes, may also occur when excessive pressure is applied to tissue (e.g., when a tourniquet is applied to an extremity or with excessive coughing or vomiting). Sunburn, childbirth, weightlifting Gua Sha, a Chinese treatment that scrapes the skin High-G training Hickey Asphyxiation Choking game Oral sex Non-infectious conditions Vitamin C deficiency, scurvy Vitamin K deficiency Leukemia Thrombocytopenia – Low platelet counts or diminished platelet function (e.g., as a side effect of medications or during certain infections) can give rise to petechial spots clotting factor deficiencies – (Von Willebrand disease) Hypocalcemia Idiopathic thrombocytopenic purpura Coeliac disease Aplastic anaemia Lupus Kwashiorkor or Marasmus – Childhood protein-energy malnutrition Erythroblastosis fetalis Henoch–Schönlein purpura Kawasaki disease Schamberg disease Ehlers–Danlos syndrome Sjögren syndrome – Petechial spots could occur due to vasculitis, an inflammation of the blood vessels. In such a case immediate treatment is needed to prevent permanent damage. Some malignancies can also cause petechiae to appear. Radiation Fat embolism syndrome Infectious conditions Babesiosis Bolivian hemorrhagic fever Boutonneuse fever Chikungunya Cerebral malaria Congenital syphilis Crimean–Congo hemorrhagic fever Cytomegalovirus Dengue fever Dukes' disease Ebola Endocarditis Influenza A virus subtype H1N1 Hantavirus Infectious mononucleosis Marburg virus Neisseria meningitidis Rocky Mountain spotted fever Scarlet fever Typhus Streptococcal pharyngitis – Petechiae on the soft palate are mainly associated with streptococcal pharyngitis, and as such it is an uncommon but highly specific finding. Forensic science Petechiae on the face and conjunctiva (eyes) are unrelated to asphyxiation or hypoxia. Despite this, petechiae are used by police investigators in determining whether strangulation has been part of an attack. The documentation of the