Bleeding into the skin

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Bleeding into the skin

Aside from the common bruise, bleeding into the skin or mucous membranes is a very significant sign and should always be evaluated. Bleeding that consists of pinpoint dots of blood is called petechiae. Larger flat areas where blood has collected under the tissue, up to a centimeter in diameter, are called purpura. A very large area is called an ecchymosis.

Redness of the skin (erythema) should not be mistaken for bleeding. Petechiae, purpura, and ecchymosis do not blanch (become pale) with pressure, while the redness of erythema decreases and then returns when pressure is applied and released.

• Injury or trauma
• Allergic reaction
• Autoimmune disorders
• Viral infection or illness affecting blood coagulation
• Thrombocytopenia
• Medical treatment, including radiation and chemotherapy
• Antiplatelet medications such as clopidogrel (Plavix)
• Bruise (ecchymosis)
• Birth (petechiae in the newborn)
• Aging skin (ecchymosis)
• Idiopathic thrombocytopenic purpura (petechiae and purpura)
• Henoch-Schonlein purpura (purpura)
• Leukemia (purpura and ecchymosis)
• Drugs
  • Anticoagulants such as warfarin or heparin (ecchymosis)
  • Aspirin (ecchymosis)
  • Steroids (ecchymosis)
• Septicemia (petechiae, purpura, ecchymosis)

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