In the differential diagnosis of recurrent ecchymoses
and bleedings, this condition should also be considered and the patients should be examined carefully in terms of association of hematological and other diseases.
Metastatic neuroblastoma typically leads to the development of 'raccoon eyes' (periorbital ecchymoses
due to local periorbital infiltration and probable obstruction of the palpebral blood vessels) (Fig.
The peri-umbilical and flank ecchymoses
are common in rectus sheath haematoma.
In the childhood, ecchymoses
start; epistaxis, bleeding after surgery and gingival bleeding constitute the other findings (3).
It is characterized by development of painful edematous skin lesions that progress to ecchymoses
during the following 24 h (5).
Then painful ecchymoses
and petechiae appear on the face and extremities or large target lesions may erupt suddenly.
The most common adverse events observed during the double-blind, placebo-controlled portions of three clinical trials in patients with psoriasis were infections, injection-site reactions, headaches, and injection-site ecchymoses
. There were no reports of opportunistic infections or tuberculosis during 662 patient exposure years.
The cutaneous damage from radiation injury may manifest as ecchymoses
, petechiae, bullae, epidermal sloughing, ulceration, hair loss, hyperkeratosis, and stochastic radiation reactions with long-term carcinogenesis.
One patient presented with petechiae, one with simple ecchymoses
, and one with noninflammatory retiform purpura.
The telltale findings are a central ulcer with a surrounding ring of purple ecchymoses
, which is surrounded by a slowly advancing ring of erythema, Dr.
TREATMENT: Because of his good clinical appearance, you elect to treat him with oral amoxicillin and send him home with careful instructions to return promptly if he develops any petechiae below the clavicular line or any ecchymoses
anywhere or any high fevers.
Complications occurred in 12 cases (11 with small ecchymoses
at injection sites and one with excessive bleeding from the needle stick), for a rate of 1.2%.