Ecchymosis is a condition marked by usually non-raised or flat, bluish or reddish skin discoloration which occurs at random due to some underlying medical disorder. The skin discoloration occurs due to the seepage of blood from burst or ruptured vessels into the tissues. It can be categorized as a subcutaneous purpura; it is not the same as a bruise and measures about 1 cm or more diametrically.
Purpura refers to a skin condition marked by purplish discolored patch on skin which occurs due to leakage of blood into the tissues or capillaries. When it occurs in large size or is widespread then it is known as ecchymosis, while it is called petichiae when their size is smaller and less extensive. Thus, the platelets are involved in purpura and ecchymosis. Affected individuals may suffer from low platelet count or they may have normal platelets. Platelets are a kind of disc-shaped blood cell contain clear fragments and without a nucleus. They cannot be considered as real cells, but are fractions of blood cells, light in nature, and typically occur on the blood vessels walls where it performs all its functions.
Ecchymosis can be defined as a type of hematoma with skin anomalies that are over 10 mm to 1 cm or more in size. It is identified as an extravasation of blood in the skin’s thin layer, which in turn occurs due to seepage of blood into that region from ruptured blood vessels.
People occasionally mistake it for a bruise, but ecchymosis and bruises have completely different causes. Ecchymosis occurs spontaneously as an effect of some underlying disease, while bruises cause blood leakage into the skin’s thin layer due to trauma to the affected area.
Ecchymosis is typically not accompanied by a variety of signs and symptoms. The minor and common symptoms may however be accompanied by the symptoms of the underlying causative medical condition.
Some of the symptoms of ecchymosis are listed below:
- Formation of discolored patches on the skin; they may be purplish, reddish, or bluish in color.
- The discolored skin patched may measure 1 cm or more diametrically
- The unaffected sections of the skin adjacent to ecchymosis abnormalities may experience inflammation, which in turn is dependent on the severity of tissue damage.
- Some patients may experience pain in the affected sites; it is however very rare.
- In severe cases, the skin discolored may spread to the surrounding areas from the original affected site.
- Both, hematoma and ecchymosis, are caused due to blood leakage into the tissues from ruptured blood vessels. The difference between the two lies not just in their appearance but also in the sites that each of them affect.
- Ecchymosis occurs in the mucous membrane and the skin’s thin layer, while hematoma can affect not just the skin’s thin layer and the mucous membrane but also varied body organs. Hematoma is usually raised and 3-dimensional while ecchymosis skin defects are flat.
Ecchymosis is usually not considered as a disease or a disorder on its own; it is usually harmless. It is however regarded as a symptom of some other severe underlying ailment which needs to be medically treated. Ecchymosis occurrence may be as part of a minor inflammatory reaction of the body, or it may be part of a more serious condition.
The discolored patches on skin associated with ecchymosis occur due to rupture of the blood vessels and subsequent leakage of blood into the thin layer of skin, tissues, or in mucous membranes. Such blood cannot come out from the skin as there are no cuts or breaks on the skin on the affected site; they then get collected beneath the skin surface, thereby causing the purplish, bluish, or reddish discoloration.
In addition to being an inflammatory reaction of the body, ecchymosis and the associated rupturing of blood vessels may occur due to the underlying presence of the below listed conditions:
- Cirrhosis of the liver: It is a condition marked by abnormalities in the structure and function of the liver. It may develop as part of complications of varied pre-existing liver ailments. Dysfunction of the liver or impaired liver functioning can change the composition of the blood which can then give rise to ecchymosis.
- Leukemia: Leukemia is a type of cancer of the blood cells, also including malignancy of the tissues that make blood. Elevation in the levels of WBCs is what triggers ecchymosis development. Leukemia associated ecchymosis is marked by easy bleeding and bruising.
- Multiple myeloma: It is malignancy of the body’s plasma cells, which are a form of WBCs typically occurring in the bone marrow. The progression of the disease is marked by growth of abnormal plasma cells in the bone marrow, thereby leading to blood anomalies and subsequently resulting in ecchymosis.
- Acute renal failure: It is a condition marked by rapid deterioration and loss of kidney function, which then adversely affects the process of waste elimination from the body, thereby increasing waste matter content in the blood. Such excessive waste accumulation in blood is what eventually causes ecchymosis.
- Myelofibrosis: It is marked by fibrosis development in the tissue of the bone marrow, which then hampers normal blood cells production in the body, thereby causing ecchymosis.
No medical treatment is required for ecchymosis. It can be resolved via home remedies. However, patients who suffer from severe pain and frequent bouts of ecchymosis need to visit a doctor. In such cases, the doctor may diagnose the underlying causative disease and then treat it as per relevant and set medical procedures.
A few treatment options of ecchymosis include:
- Any pain can be alleviated with pain killers and other analgesics.
- Application of ice on the affected areas will allow vasoconstriction of the ruptured vessels which will then prevent spread of ecchymosis to adjacent areas.
- Take sufficient rest as it helps healing of the affected tissues.
- Keep the affected site in an elevated position. It will permit correct venous return, improve circulation to the area, and help curb inflammation.
- Mild stretching exercises and massages can also promote repair of the affected tissue. However, ensure that these activities are not too harsh or prolonged, as doing so can further damage the tissues and worsen ecchymosis.