Ecchymosis: 7 things to know about bruising and cancer

If you’ve ever bumped your shin on a car door, dropped something heavy on your foot by accident, or taken a tumble off a bicycle, you’re probably familiar with bruises.

They start out as red discolorations of the skin after an injury, then take on a purple, blue or greenish-yellow hue before fading away completely over the course of several weeks.

But can bruising ever be a symptom of cancer? If so, how does it differ from regular bruising, and when should you see a doctor about it?

We went to leukemia specialist Wei Ying Jen, BM BCh, for insight. Here’s what she shared.

What’s the difference between ecchymosis and a regular bruise?

There is none. Ecchymosis, also called a contusion, is just the technical term for a bruise.

What’s the difference between ecchymosis and hematoma?

They’re basically the same thing. The terms are often used interchangeably. Hematoma just means that blood has collected outside of a vessel. It appears as a raised lump under the skin, while other bruises are flat. It can also happen in other places within the body that may not be visible externally.

What’s the main cause of ecchymosis?

Anything that damages the small blood vessels under the skin can cause it. So, it’s usually due to trauma, like sports injuries or being in a car accident.

Can ecchymosis ever be a symptom of cancer?

Yes. But it can also be a side effect of some cancer treatments. Anything that drops your platelet count (a condition called thrombocytopenia) can cause bruising, because your body can’t respond to bumps and other minor injuries the way it normally would.

As a symptom, we tend to see bruising most often with leukemia and lymphoma patients.

As a side effect, we see it most often in patients receiving chemotherapy. But the bruising you’d typically see with leukemia looks a little different than regular bruises. It shows up as groups of tiny pinpoint dots or little red spots called petechiae. Slightly larger spots called purpura can also be a sign of low platelet counts or a bleeding disorder.

Why else might someone bruise easily?

In our daily lives, we encounter lots of bumps that ordinarily never cause trouble, because the body is so good at healing itself without us noticing. Blood thinners and other medications can interrupt this process, so when capillaries just under the skin surface are injured, the healing/clotting process is impaired.

This can lead to what’s known as spontaneous bruising, because even something like the handle of a grocery bag can cause it, though it’s not bearing down very hard on your skin.

A vitamin K deficiency can also cause you to bruise easily, but those are very rare. And, blood disorders like hemophilia tend to cause bleeding in the joints, rather than on the skin.

How is ecchymosis treated? Is treatment even needed?

No. Not really. At UT MD Anderson, we give leukemia patients infusions to boost their platelet levels, but there’s no specific treatment for bruising. Over time, they generally resolve on their own.

When should you see a doctor about bruising?

If you just have one bruise, it’s going to be absolutely nothing nine times out of 10. But see a doctor for any bruising that is unexpected or recurrent, especially if it’s not easily explained by trauma. And, if it comes on suddenly and is really big and painful, go to an emergency room.

Request an appointment at UT MD Anderson online or call 1-877-632-6789.