Introduction:
Sometimes, people notice an unusual bruise over the body; the bruise can be ideally from any injury to the body or cells. The bruise is displayed as discoloration over the body. It can be differentiated from the body as it has a different color and sometimes presents with a symptom of pain. These bruises are ecchymosis. Locoregional ecchymosis is an ecchymosis that is present in a localized region of the body.
What is Ecchymosis?
Ecchymosis is usually known as a bruise. In addition, it is referred to as skin discoloration due to the rupture of blood vessels below the skin's surface. Ecchymosis is sometimes confused with purpura because it has purplish patches that do not blanch on applying pressure, as these become white or pale in appearance. Generally, these ecchymoses are more than one centimeter in size and usually take one to three weeks to heal completely. There are different types of discoloration that are similar to ecchymosis, but they are differentiated according to their size. They are:
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Hematomas - They are generally present in larger sizes with better coverage of the body. But they are firm, raised from the body, and painful too.
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Petechiae - These are the pinpoint spots on the skin that are usually less than 0.3 centimeters in diameter. These petechiae are tiny spots formed due to broken capillaries under the skin.
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Purpura - These are larger than petechiae but smaller than ecchymosis. It appears as a small reddish or purplish spot usually found under the skin.
What Is Locoregional Ecchymosis?
Locoregional ecchymosis is an ecchymosis that is present in a localized area. It is referred to as a blue or purple color skin discoloration that is formed due to rupturing of blood vessels present under the skin. Sometimes this ecchymosis is accompanied by pain and tenderness. These are usually due to trauma or injury over the area but can also be due to underlying diseases or conditions. Some of the common medical conditions that cause ecchymosis are aplastic anemia, liver cirrhosis, renal failure, and vitamin K deficiency.
What Are the Causes of Ecchymosis?
The causes of ecchymosis:
1. Ecchymosis is usually formed by an injury like a fall or blow. The injury further causes the blood vessels to burst and form an open leakage of the blood from the vessel present under the skin, thus creating a bruise. For example, a trauma in the eye can sometimes cause periorbital ecchymosis, which can make a person have a raccoon eye formation.
2. Many medicines are also associated with bruising and ecchymosis, like blood thinners Aspirin or Warfarin, antibiotics, and corticosteroids.
3. There are a few medical conditions that can cause ecchymosis. Some of them are:
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Leukemia - A cancer of blood-forming cells.
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Kidney failure.
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Vitamin K deficiency.
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Liver cirrhosis (chronic liver damage with failure).
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Aplastic anemia, a condition when the bone marrow stops the production of new cells due to autoimmune disease, and the destruction of stem cells occurs in the bone marrow.
How Is Locoregional Ecchymosis Formed?
When the injury on the surface of the skin occurs, the blood vessel present under the skin bursts, and opens. Then the blood starts leaking from the injured vessels into the subcutaneous space present beneath the skin, where it forms a small pool that turns the skin purple, black, or blue. As the blood vessel gets injured, the platelets start their work of clotting. The clothing process blocks the blood vessels from leaking any further blood. Thus, it makes the bruises bigger, and soon the healing process starts.
What Are the Different Types of Locoregional Ecchymosis?
Different types of locoregional ecchymosis are:
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Periorbital Ecchymosis - Ecchymosis formed near the eye due to trauma is called periorbital ecchymosis, also known as raccoon eye. It is usually associated with a Battle's sign (discoloration or ecchymosis behind the ear, which is present due to underlying brain trauma).
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Umbilical Ecchymosis - The ecchymosis present surrounding the umbilical region is called umbilical ecchymosis. It is associated with Cullen's sign, usually seen in cases of liver cirrhosis and pancreatitis or even the cyst within the abdominal cavity. Cullen's sign indicates the presence of retroperitoneal hemorrhage.
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Lateral Abdominal Wall Bruising - It is associated with the Grey-Turner sign, which is usually seen when there is a rupture of an abdominal aneurysm or spleen, an intrauterine pregnancy, or bilateral salpingitis (associated with inflammation of fallopian tubes), hemorrhagic pancreatitis. Grey-Turner sign also indicates retroperitoneal hemorrhage.
What Are the Signs and Symptoms of Locoregional Ecchymosis?
Ecchymosis includes:
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Bluish purple discoloration, which is limited to the upper layer of skin.
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It is not raised like hematomas.
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They can be one centimeter small to more than one centimeter large.
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They can show tenderness on touching.
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They can show pain.
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They are accompanied by inflammation and swelling.
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As the healing starts, it sometimes changes from dark purple to blue to yellow or even green. This process is due to the breakdown of hemoglobin.
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It is frequently seen in children who are active.
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They are usually over the areas that have thinner skin, like lips or eyelids.
What Is the Treatment of Locoregional Ecchymosis?
Ecchymosis needs to be diagnosed along with the underlying causes with the help of blood tests. Usually, ecchymosis requires no treatment as it heals on itself, but the underlying causes need to be treated. But as it develops, initial use of cold compression over the area can cause the blood vessels to constrict and prevent the spreading of the blood. If the patient is feeling pain, the use of Acetaminophen can relieve the symptom.
Conclusion:
Locoregional ecchymosis is bruises that are localized to an area. These ecchymoses are usually seen due to trauma over the area or can be due to an underlying disease like vitamin K deficiency, aplastic anemia, or liver cirrhosis. They are accompanied by symptoms like pain, tenderness on touch, and discoloration of the area, which changes color on healing. They can be confused with hematomas, petechiae, or purpura. There are different types of locoregional ecchymosis, like periorbital ecchymosis and umbilical ecchymosis, some indicating the presence of underlying diseases.
