Flash information
- Lesion
- Larger cutaneous haemorrhage
- Surface
- Usually intact skin
- Context
- Trauma or spontaneous bleeding
- Predisposition
- Skin fragility, medicines
Definition
An ecchymosis is cutaneous blood extravasation larger than petechiae, without necessarily forming a deep collection.
Examination or reading method
Ask about trauma and medicines; examine mucosa and other sites and review previous bleeding.
Morphological description
Measure extent and describe borders, colour and pain; swelling may suggest a haematoma.
Causes and diagnostic direction
Trauma, platelet or coagulation disorders and antithrombotic treatment may predispose to bruising.
Differential diagnoses
Actinic purpura produces recurrent bruises on thin skin, often on the forearms.
Associated findings
On sun-exposed areas, look for skin thinning and older lesions; consider corticosteroids and anticoagulants.
Red flags
A new widespread presentation or additional bleeding should not automatically be attributed to age-related fragility.
Pitfalls and limitations
Colour is not a reliable clock; a photograph cannot quantify deep bleeding.
Take-home message
Distinguish an isolated bruise from a bleeding syndrome; fragile skin does not explain every bleed.
Media source & rights
- Author
- James Heilman, MD
- Original source
- James Heilman, MD — Echymosis.jpg — CC BY-SA 4.0 — https://commons.wikimedia.org/wiki/File%3AEchymosis.jpg
- Licence
- CC BY-SA 4.0
- Changes
- Orientation EXIF normalisée ; conversion WebP et redimensionnement proportionnel plafonné à 1600/400px ; aucun recadrage, aucune retouche médicale ; EXIF supprimé. Dérivé écran proportionnel ≤1280 px, WebP qualité76 ; vignette ≤320 px qualité72. Source acquise et dérivé initial conservés sans modification ; aucune retouche médicale, aucun recadrage.
- Dimensions
- 985 × 1280 px
- Check
- 2026-10-11