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Forum Name: Dermatology Topics

Question: Unexplained and painless bruising along with skin patches


 thester6474 - Tue Sep 01, 2009 7:39 pm

User avatar What can cause unexplained bruising?
I have over the last month or so been noticing a ton of unexplained bruising appearing on my arms and legs. They are painless and vary in size. I also have these small red dots on my arms and legs, some right in the middle of the bruises. I also have these darkening areas on my wrist, ankle and stomach that has over the last month become ten times darker and spread. A few of my toe nail beds have these black discolorations and are very brittle. What could be causing these symptoms?
 Dr.M.jagesh kamath - Thu Sep 03, 2009 12:04 pm

User avatar Hello,In a case of multiple ecchymosis I would first ask for medications.Many drugs are capable of inducing thrombocytopenias and resultant bleeding in to the skin.Also bleeding and clotting disorders need to be ruled out.A peripheral smearto rule out hematologic conditions is required.Though uncommon VitC deficiency needs to be considered.I would also get investigations to rule out a connective tissue disorder like lupus.Lastly congenital causes,like ecchymotic form of ehlers danlos syndrome, if there are other features accompanying needs to be thought of.Do get investigated along these lines.If none is found easy bruising syndrome could be considered too.Do keep in touch.Hoping you would recover soon.
 thester6474 - Fri Sep 11, 2009 4:48 pm

User avatar Because I have several different illnesses, my Rheumatologist has bloodwork, as well as a UA, done every two months. I currently have Fibromyalgia, Myoclonus, Hypermobility Syndrome, Lyme Disease, Restless Leg Syndrome, Neuropathy, Hypertension, Unspecified Tachycardia, Anxiety Disorder, Gastrointestinal Upset, Kyphosis, Mild Early Degenerative Disc Dessication, B-12 Deficiency, Depression, Mild Central Canal Stenosis (Spine), Scoliosis, Chronic Rhinitis, Osteopenia, Mild Diffuse Annular Bulging, Tension Headache, Lumbago, Sciatica, Chronic Maxillary Sinusitis, a persistent Ganglion Cyst (which shows back up within 24 hours of being removed) and a Nasapharyngeal Mass. Last Thursday, I went to his office to have my labs done. I have taken Intramuscular B-12 every two weeks to month for the last three years. Today I got a call and was prescribed Iron and Vitamin C daily, as well as a medication for my kidney's, I am not really sure why. My doctor's have been sure that there is something else wrong, and insisted that I go to either Duke University or Emory University for a complete checkup. Do you still think that it would be in my favor to be tested for the other things you mentioned as well? Two months ago when I had my labs done, all my values were normal, can they become abnormal that quickly?
 Dr.M.jagesh kamath - Fri Sep 11, 2009 11:01 pm

User avatar Hello,Though I have quoted many differential diagnosis,with the earlier normal values I feel what you have is only easy bruising syndrome which is very benign.Do get tested as per recommendations but this diagnosis is my personal impression.Do keep in touch.Ref-1: Ann Intern Med. 1975 Aug;83(2):190-6.
 thester6474 - Wed Sep 30, 2009 7:53 pm

User avatar I have been on the Vitamin C and Iron for almost three weeks now, I haven't seen any difference as of yet, but I know that it could take a while. I was just concerned still about the skin splotches that are on my legs. There are at least five or six splotches on my right leg alone. I am also concerned about the areas on my wrist and ankles that are scaly, long and brown, and have grown dramatically in size in the last few months. The right side of the same ankle is becoming discolored and scaly as well. My other concern would be the discolored toenail, it started out as a line, maybe a mm thick and black. It appears on the same ankle that the discoloration is on. It is now takes up about a quarter of my nail and is black and red. It has been present at least a month, and is growing slowly, but nonetheless still growing. Should I see a Dermatologist, do you think that the two different discolorations may be linked? And in your professional opinion what would you search for?
 Dr.M.jagesh kamath - Thu Oct 01, 2009 2:49 am

User avatar Hello,The darkened nail with scaly lesions can be a presentation of lichen planus which can present as violaceous leisions,at the legs and wrist area.Nail atrophy,darkening of nails,and brittleness are associated with LP in a few cases.A biopsy may settle the diagnosis.Drug induced LP may be my line of thinking.

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