Ecchymosis: Skin discolouration due to bleeding

What is ecchymosis?

Ecchymosis refers to the discoloration of skin in a large area due to extravasation (forcing out) of blood into the subcutaneous tissues (tissues below the skin).

echymosis

Causes

The bleeding underneath the skin can arise due to various reasons including:

  • Trauma or injury
  • Autoimmune disorders
  • Allergic reactions
  • Ageing skin
  • Bruising
  • Spleen rupture
  • Acute renal (kidney) failure
  • Acute pancreatitis (inflammation of pancreas)
  • Thrombocytopenia (platelet deficiency in blood)
  • Liver cirrhosis
  • Leukaemia
  • Certain medications like anticoagulants (inhibit or slow down blood clotting)
  • Septicaemia (spread of bacteria in blood)
  • Medical treatment including cosmetic procedures

Symptoms

The usual symptoms of ecchymosis include:

  • A reddish to purplish skin discolouration
  • Pain perception in the region, though not always present
  • Inflammation around the surrounding skin of varying degree

Diagnosis

bloodtest

To diagnose ecchymosis and its probable cause, your doctor will question about your medical history, including the history of bleeding, the medications you are currently taking, and about any recent injuries or surgeries.

Following tests may be recommended:

  • Complete and differential blood counts with platelet counts
  • Coagulation tests
  • Biopsy of the bone marrow

Treatment

Ecchymosis treatment usually includes:

  • Rest to promote healing, resorption of blood and repair of the site
  • Elevation of the affected region can aid in inhibition of inflammation and improve circulation
  • Application of ice to prevent ecchymosis to adjoining areas
  • Medications are prescribed for managing the pain
  • Novel approaches include the use of a gel with hydrogen peroxide to reduce discolouration and discomfort.

Prevention

Ecchymosis may not always be prevented. However, Stopping anticoagulant medication and herbal supplements before any surgical procedures are known to decrease its incidence.

Complications

Minor bleeding underneath the skin due to injuries aren’t the cause of worry. However, injury to the affected region may lead to prolonged bleeding, anaemia, infections and loss of function of the concerned part of the body.

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References

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  • Molenda MA, Sroa N, Campbell SM, Bechtel MA, Mitch Opremcak E. Peroxide as a Novel Treatment for Ecchymoses. The Journal of Clinical and Aesthetic Dermatology. 2010;3(11):36-38.
  • Bleeding into the skin. NIH U.S. National Library of Medicine. https://medlineplus.gov/ency/article/003235.htm. Accessed 17 Nov. 16.
  • A Review of Clinical Signs Related to Ecchymosis. Epperla N et al. Wisconsin Medical Society.
  • https://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/114/2/61.pdf. Accessed 17 Nov. 16.

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