Bruising
Basics
Description
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
Epidemiology
Prevalence
- <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.
Genetics
- Hemophilia is an X-linked disorder affecting males.
- von Willebrand disease may be autosomal dominant.
- Other platelet disorders have a variety of inheritance patterns.
Pathophysiology
Extravasation of blood from blood vessels leading to a collection of blood below the surface of the skin
Etiology
- Disorders of blood vessels and surrounding tissue
- Platelet abnormalities (function, number)
- Coagulation disorders
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Citation
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 MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617320/all/Bruising. Accessed December 4, 2024.
Bruising. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617320/all/Bruising
Bruising [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2024 December 04]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617320/all/Bruising.
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