By Gary M. White, MD
A bruise (medical term ecchymosis--plural, ecchymoses) is discoloration of the skin caused by the leakage of blood out of the blood vessels.
- The age of a bruise can be estimated by its color [Arch Dis Child 1996;74;53]. Red color occurs only from 0-7 days. Yellow is only seen after 24 hours and green after 48 hours. Thus a green or yellow color indicates the lesion did not occur that day.
- See also easy bruising and solar purpura.
Differential Diagnosis for Easy Bruising
- Chronic steroid use (topical or systemic)
- Aging and the sun (occurs most commonly in the elderly on the arms)
- Acute idiopathic thrombocytopenia (acute onset, usually with bleeding from other sites and a prolonged bleeding time)
- Coagulation disorders (altered coagulation profile)
- Child abuse (ruled out by a careful history and the absence of suggestive bruises elsewhere)
- Inherited giant platelet disorders
The chronic use of steroids, either topical or systemic, can lead to easy bruising (steroid purpura). Getting older is associated with easy bruising as well (solar purpura).
If workup is needed, laboratory testing with a focus on platelets, bleeding times, and coagulation factors may be done.
Various inherited disorders may be associated with fewer and larger platelets (macrothrombocytopenia); these disorders are grouped together as inherited giant platelet disorders. For more information, see Indian J Dermatol Venereol Leprol 2015;81:633-5.
A woman who fell and hit her arm three days before showing a range of colors and an interesting follicular pattern.
Bruise on the shin of an elderly man showing a range of colors.
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