Diagnosis and management of onyalai

Onyalai is diagnosed by finding the combination of haemorrhagic blisters in the mouth and severe thrombocytopenia, and by excluding other possible causes of thrombocytopenia. Patients improve rapidly with appropriate therapy. Haemorrhagic shock should be corrected with intravenous fluid and blood transfusion. Corticosteroids should be given in large doses initially, then tapered off and stopped over a period of several weeks. Occasional patients may require more prolonged steroid therapy.