MedlinePlus Medical Encyclopedia: Bleeding into the skin

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Bleeding into the skin

Contents of this page:
Illustrations Alternative names Definition Considerations	Common Causes Home Care Call your health care provider if What to expect at your health care provider's office

Illustrations

Black eye

Alternative names Return to top

Ecchymoses; Skin spots - red; Pinpoint red spots on the skin; Petechiae

Definition Return to top

Aside from the common bruise, bleeding into the skin or mucous membranes is a very significant sign and should always be evaluated. Bleeding that consists of pinpoint dots of blood is called petechiae. Larger flat areas where blood has collected under the tissue, up to a centimeter in diameter, are called purpura. A very large area is called an ecchymosis.

Considerations Return to top

Redness of the skin (erythema) should not be mistaken for bleeding. Petechiae, purpura, and ecchymosis do not blanch (become pale) with pressure, while the redness of erythema decreases and then returns when pressure is applied and released.

Common Causes Return to top

Injury or trauma
Allergic reaction
Autoimmune disorders
Viral infection or illness affecting blood coagulation
Thrombocytopenia
Medical treatment, including radiation and chemotherapy
Bruise (ecchymosis)
Birth (petechiae in the newborn)
Aging skin (ecchymosis)
Idiopathic thrombocytopenic purpura (petechiae and purpura)
Henoch-Schonlein purpura (purpura)
Leukemia (purpura and ecchymosis)
Drugs
- Anticoagulants such as warfarin or heparin (ecchymosis)
- Aspirin (ecchymosis)
- Steroids (ecchymosis)
Septicemia (petechiae, purpura, ecchymosis)

Home Care Return to top

For aging skin, protection of skin is recommended. Avoid trauma such as bumping or pulling on skin areas.

For a cut or scrape, use direct pressure to stop the bleeding.

For a drug reaction, identify and consult the health care provider about discontinuing the drug.

Otherwise, follow prescribed therapy to treat the underlying cause.

Call your health care provider if Return to top

There is sudden bleeding into the skin for no apparent reason.
If there is persistent, unexplained bruising.

What to expect at your health care provider's office Return to top

Your doctor will perform a physical examination and ask questions about the bleeding, such as:

Has there been a recent injury or accident?
Have you been ill lately?
Have you had radiation therapy or chemotherapy?
What other medical treatments have you had?
Do you take aspirin more than once a week?
Do you take Coumadin, heparin, or other "blood thinners" (anticoagulants)?
Has it occurred repeatedly?
Has a tendency to bleed into the skin been present lifelong?
Did it start in infancy (for example, with circumcision)?
Did it start with surgery or a tooth extraction?

The following diagnostic tests may be performed:

Coagulation tests including INR and prothrombin time
CBC with platelet count and blood differential
Bone marrow biopsy

Update Date: 9/8/2003

Updated by: A.D.A.M. editorial. Previously reviewed by Anthony E. Douglas, M.D., Department of Primary Care Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network (1/17/2002).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.