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Bruising is a topic covered in the 5-Minute Pediatric Consult.

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Bruises are the result of extravasation of blood into the skin. Conventional usage often groups petechiae and bruises (or ecchymoses) together as purpura and defines them as follows:

  • Petechiae: flat, red, or reddish purple; 1 to 3 mm; nonblanching
  • Ecchymoses: larger than petechiae, local extravasation, nonpulsatile, sometimes palpable, color depends on age of lesion



  • <1% nonmobile babies
  • 17% cruising and crawling infants
  • 53% walkers
  • Majority of school age children

Risk Factors

Underlying bleeding disorders (e.g., von Willebrand disease, platelet disfunction, thrombocytopenia), child abuse/trauma, medications, infections, etc. may all be risk factors leading to bruising in childhood.


  • Hemophilia is an X-linked disorder affecting males.
  • von Willebrand disease may be autosomal dominant.
  • Other platelet disorders have a variety of inheritance patterns.


Extravasation of blood from blood vessels leading to a collection of blood below the surface of the skin


  • Disorders of blood vessels and surrounding tissue
  • Platelet abnormalities (function, number)
  • Coagulation disorders

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Cabana, Michael D., editor. "Bruising." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617320/all/Bruising.
Bruising. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617320/all/Bruising. Accessed April 20, 2019.
Bruising. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617320/all/Bruising
Bruising [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 20]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617320/all/Bruising.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bruising ID - 617320 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617320/all/Bruising PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -