What Is Ecchymosis?

For skin and mucosal hemorrhagic patchy lesions,

Bruises

Overview of ecchymosis

For skin and mucosal hemorrhagic patchy lesions,

The nature is the same as the bleeding point,

More tips for blood diseases

Or the disease caused bleeding and coagulation abnormalities.

Common ecchymosis

1. Epidemic hemorrhagic fever: bleeding spots or ecchymoses of various sizes appearing in the oral mucosa, chest and back, or underarms, or cord-like, scratch-like bleeding points.

2. Thrombocytopenic purpura: petechiae and ecchymosis can occur in any part of the skin and mucous membranes, but more in the distal extremities.

3. Cerebrospinal meningitis: There may be petechiae and petechiae on the skin and mucous membranes.

4. Sepsis: Various skin injuries can be seen, with petechiae, petechiae, scarlet fever-like rash, and measles-like rash are common.

5. Trauma: Deep purple bruises will appear on the skin after the injury. In severe injuries, hematoma may occur.

6, allergic purpura: mostly manifested as skin purpura. Purpura varies in size and can be fused into tablets to form ecchymosis. Purpura is mainly restricted to the limbs, especially the lower limbs and buttocks.

7, acute leukemia: more than a few patients have bleeding, varying degrees of severity, parts can be throughout the body, manifested as petechiae, petechiae, nosebleeds, bleeding gums and more menstrual bleeding, fundus bleeding.

Causes of ecchymosis

(1) Extravascular factors. If the tissue around the blood vessel is weak due to degeneration, atrophy and relaxation, it will be prone to bleeding and purpura. Extravascular factors are more common in senile or cachexia purpura. Capillary and small blood vessels can be ruptured and hemorrhage caused by slight external force.

(2) Vascular factors. It refers to purpura which is formed by the blood vessel wall oozing out of the blood vessel. Purpura caused by vascular factors accounts for the top of all purpura. After normal small blood vessel injury, reflex contraction of blood vessels immediately occurs, and local blood flow is slowed to promote hemostasis. If the surrounding blood vessels are fragile, the permeability is increased, and the vasomotor function is abnormal, it is easy to cause hemorrhagic purpura because the blood leaks from the inside and outside of the blood vessels. The vascular factor-induced bleeding is characterized by a positive capillary fragility test, but the bleeding time and clotting time are normal. The most common type of purpura is allergic purpura. Second, bacterial or viral infections, vitamin C deficiency, and chemical factors can all cause damage to blood vessel walls and cause purpura. In addition, there is an unexplained increase in the fragility of the blood vessel wall, which is common in women. Purpura can go away on its own without adverse effects.

(3) Platelet factor. Platelets play an important role in the process of hemostasis. Thrombocytopenia or deficiency of platelet function weakens or loses hemostatic function, which is likely to cause purpura. Thrombocytopenia can be seen in idiopathic thrombocytopenia, secondary thrombocytopenia (also known as symptomatic purpura, which can reduce thrombocytopenia due to bone marrow hematopoietic disorders, seen in aplastic anemia, leukemia, cancerous bone metastases), radiation Substances and chemicals destroy megakaryocytes and reduce platelet production, and severe infections (such as typhoid fever, meningoencephalitis, and sepsis) cause excessive destruction of platelets. In addition, hypersplenism, lupus erythematosus, and uremia can also reduce platelets. Platelet dysfunction diseases include hemorrhagic thrombocytosis, platelet weakness, and the like. Laboratory tests are of great significance in the diagnosis of purpura caused by platelet factors, and are generally manifested by prolonged bleeding time, poor blood clot retraction, and thrombocytopenia.

(4) Factors of coagulation factors. Lack of coagulation factors often leads to coagulopathy and leads to purpura. There are fewer such diseases, most of which are congenital, and a few are acquired (mainly caused by liver disease). For patients with purpura, relevant tests such as blood routine, platelet count, bleeding time, clotting time, capillary fragility test, microcirculation of skin and mucosa, blood rheology, and coagulation factors should be performed.

Ecchymosis test

1. Vascular purpura. Very common, due to vascular wall damage or increased fragility and permeability, common in immune (such as allergic purpura), infectious (such as sepsis), and abnormal vascular structures (such as hereditary bleeding capillaries Dilated disease) and other diseases (such as abnormal proteinemia, simple or senile purpura, etc.). Except that the beam arm test may be positive, there are no other abnormalities.

2. Platelet abnormal purpura. Most commonly, it is caused by thrombocytopenia, increase, and abnormal function. If there is purpura or blisters in the buccal mucosa, it usually indicates severe bleeding and should be actively treated.

3. Impaired coagulation mechanism, including lack of coagulation factors, circulating anticoagulant substances or fibrinolysis, generally speaking, bleeding caused by coagulation mechanism disorders is mainly manifested by joint hemorrhage, muscle hematoma and visceral bleeding, and less skin Purpura, which sometimes appears as a large ecchymosis, and check for obvious abnormalities in blood clotting, can be distinguished from purpura caused by vascular purpura and platelet abnormalities. Treatment of purpura varies depending on the cause.