Collagen Disorder
Inherited collagen disorders like Ehlers–Danlos syndrome (EDS) can also cause petechiae or tiny pinpoint spots caused by hemorrhages under the skin. Just like the other petechiae causes, the leading cause of the appearance of these red, purple, or brown spots remains as the collapse of the blood vessels under the skin. As collagen formation gets compromised due to mutations in genes related to the encoding of the fibrillar collagen and translational enzymes, the capillaries and perivascular connective tissues weaken. Such weakening makes the blood vessels and connective tissues fragile to a variable degree, affecting medium-sized and larger blood vessels. The deterioration of the vascular tissues is believed to be caused by a molecular defect in collagen type III, a critical component necessary to keep the blood vessel walls and hollow organs safe.
The weakening of the blood vessels may result in possible rupture with the most minimal of traumas, resulting in the leaking of the blood under the skin (petechiae). But that’s not all. It may also result in extensive bruising, arterial rupture, hyperextensibility, joint hypermobility, internal bleeding, rupture of hollow organs, easy bruising, generalized connective tissue fragility, and premature death.
