Ecchymosis

What Is Ecchymosis?

The skin is considered as the biggest organ of the body as it covers each and every part and has all the properties specific to it like growth, regeneration, blood supply, nerve supply etc. It plays a very important role in protection and temperature regulation. There are many skin conditions that may affect an individual during his life span. The colour and nature of the skin problem leads us to the diagnosis and thereby treatment. One such skin problem is ecchymosis. This is not a very common problem so not many people know about it. Also it is often confused with a bruise. The following are some differentiating points between the three (Ecchymosis, Bruise and Purpura).

Ecchymosis Definition

Ecchymosis is defined as the discolouration occurring on the skin due to bleeding beneath the skin as a result of trauma to the blood vessels in the superficial layers of the skin.

The patches of ecchymosis are flat without any raised borders like that of acne or psoriasis. The pattern of ecchymosis varies from person to person. In some cases it is absolutely mild where as in others it is wide spread. At times it may also go unnoticed. These ecchymosis patches are most commonly confused with bruises. The pathology behind it is the rupture of the small blood vessels just beneath the skin giving rise to extravasated blood in the subcutaneous layers forming a patch. They are mostly 1-5 cms in size. Bruises tend to be smaller and occur due to a blunt injury on the skin. Ecchymosis on the other hand are significant of some underlying medical condition. In order to get the right treatment, it is very important for the doctor to differentiate between these skin conditions.

Another common term you may encounter is purpura. Purpura is a purplish patch on the skin due to leaking of blood beneath the skin layers but they are small in size. A bigger purpura is termed as Ecchymosis. In both cases the rupture of blood vessels is associated with a medical illness.

Ecchymosis Causes

This is basically not a disease in itself but a symptom indicating one or more underlying diseases. Ecchymosis is a symptom that draws our attention to an underlying disease. Ecchymosis is not a life threatening condition and there is no need to panic if you observe it. It can at times occur due to simple pulling of the skin and rupture of small blood vessels at a waxing session in the parlour. Immediate application of ice can help to soothe out the spots.

There are some serious medical conditions that cause ecchymosis. The common causes of ecchymosis are:

1. Multiple myeloma: It is a type of cancer affecting the plasma cells present in the bone marrow. The uncontrolled growth of these cells is called multiple myeloma and it is a life threatening condition. Plasma cells are the precursuros of white blood cells so an abnormal growth alters the immunity and leads to fragile blood vessels and ecchymosis.
2. Leukaemia: Leukaemia is a form of blood cancer which affects the cells of the blood and the tissues. It can be acute or chronic in nature. There are two types of leukaemia- lymphoid and myeloid. In chronic leukaemia, many times the diagnosis is difficult as the symptoms are not so prominent. The common symptoms are bleeding and bruising. The increase in the levels of the WBCs (white blood cells) enhances the ecchymosis.
3. Acute renal failure: Acute renal failure is the failure of the kidney functions causing a disturbance in the functioning of the body. The kidney cannot expel the wastes and so it leads to accumulation in the blood resulting in ecchymosis.
4. Cirrhosis of the liver: Liver cirrhosis is caused due to the generation and abnormal functioning of the liver cells. If the liver does not function normally, then the toxic wastes are not metabolised and their levels in the blood increase leading to ecchymosis. So it is very important to keep a check on the symptoms and tell it to the doctor so that a life threatening condition can be diagnosed in time and treated.
5. Grey Turners syndrome: Grey turners syndrome is basically the discolouration of the skin in the area between the last rib and the upper end of the hip bone. It is a bluish discolouration that results out of retroperitoneal haemorrhage or bleeding from the lining of the abdominal wall.
6. Some other conditions that may cause ecchymosis are:

• Waxing where the skin layers are pulled suddenly
• Skin of old people which becomes fragile and bleeds easily
• Allergic reactions
• Radiation and chemotherapy in cancer patients
• Medicines like aspirin, heparin and steroids
• Septicaemia

 Ecchymosis Symptoms

The symptoms are found commonly in the skin and the mucous membranes and rarely in other organs of the body. There are many symptoms that indicate that the person has ecchymosis but at times there can be overlapping. The symptoms may be due to a previous medical condition or side effect of an ongoing treatment. So it is very important to distinguish between the two as the line of treatment will vary. Also there should be no scope for self medication. The common symptoms are:

1. The discolouration of the skin is the most important symptom. There is a sudden appearance of a reddish blue patch on the skin.
2. The affected site is not raised but may be painful to touch.
3. Pain in the affected area may come and go. The tenderness may be there on the slightest touch.
4. Appearance of patches in other parts of the body few days after the first patch formed.
5. A new patch in single or multiples that may appear around the ecchymosis patch after 6-7 days of the first patch

If the patches are due to a blunt injury or bruise, they will resolve in a week. But if they increase in number and do not seem to go away on their own even after 5-6 days, then you should consult a doctor immediately to rule out some serious medical conditions.

Ecchymosis Treatment

In most of the cases, there is no need for any treatment and it resolves on its own at home. But if there is stinging pain or redness with acute inflammation then there could be an underlying cause that needs to be investigated and treated as soon as possible. The following are some of the treatment options:

1. Mild cases of ecchymosis usually resolve spontaneously. However if the inflammation remains then it will require treatment of the underlying cause. Ecchymosis is not a disease, but a symptom of the underlying pathology. Some of the palliative measures that can be applied are:
2. Use of ice packs or compression blocks of ice can help to reduce the inflammation and pain. It also prevents further leakage of blood from the ruptured blood vessels by causing vasospasm. This will prevent the spread of the patches of ecchymosis to other parts of the body. You can use a ready ice pack or crush some ice and put it in a thick towel and apply it on the affected area. Cold compress also helps to bring down the inflammation and redness.
3. Elevation of the affected area or limb helps to improve the blood flow and reduces the swelling.
4. Pain killers like ibuprofen may be given by your doctor if deemed necessary. It is important to remember that you should not take any medicines on your own.
5. Rest will fasten the recovery process. Rest is the most important practice in the treatment of ecchymosis. It helps the tissues to heal and repair and thus stops the ecchymosis from spreading further.
6. Slight pressure or a gentle massage on the affected part can improve the blood flow and the pressure can reduce the bleeding.
7. Diagnosis and treatment of the underlying medical condition.

Home Remedies for Ecchymosis

If you are concerned about ecchymosis, a balanced diet and proper rest and nourishment will help you to get better faster. Following are some of the home remedies.

• Cirtus fruits containing high levels of vitamin C help in tissue healing.
• Turmeric along with honey also helps to reduce the inflammation.
• Use lots of onions and garlic in your diet.
• Drink plenty of water and keep your body hydrated at all times.
• Take a juice of cucumber, carrot, ginger and coconut.

When to contact your doctor?

Immediately contact your doctor if you notice the following symptoms:

• Sudden bleeding within the skin without any reason
• Patches that do not go away after a week
• Acute redness or swelling of the patches
• Sudden increase in the number of patches
• Pain, redness and inflammation on the skin.

Ecchymosis Pictures

Ecchymosis |  via Wikimedia Commons