Difference Between Purpura and Ecchymosis (With Table)

Manifestations in the skin are one of the most significant signs that patients, as well as health workers, frequently overlook. These signs need medical attention. By not giving attention to these dermatological changes can put the lives of the patients in peril. Purpura and ecchymosis are dermatological manifestations that are closely related to vasculitis. 

Purpura vs Ecchymosis 

The difference between purpura and ecchymosis is that purpura is the small purple reddish discolouration on the skin and it does not blanch when external pressure is given over the spot. The discolouration spots generally measure between 3-10 mm. On the other hand, ecchymosis is the bluish or reddish discolouration on the skin and measures one than one cm.

Purpura is a purple reddish skin hemorrhage measured between 3-10 mm. The spots sometimes appear on mucous membranes, especially on the membranes on the mouth or any other organs. It occurs when blood vessels burst which causes blood to gather under the skin. It causes a purple reddish spot on the skin which ranges from large patches to small dots.

Ecchymosis is the bluish or reddish discoloration on the skin that usually occurs due to an injury and measures one cm or more than one cm. It happens when blood leaks from the blood vessels and makes a blood pool into the nearby tissue under the skin. The area of ecchymosis changes from bluish or reddish to green or yellow, as the tissue heals. It usually takes 1 to 3 weeks to heal.

Comparison Table Between Purpura and Ecchymosis

Parameters of Comparison PurpuraEcchymosis
SizePurpura is smaller in size than ecchymosis. It measures between 3-10 mm.
             
Ecchymosis is larger compared to purpura. It measures 1 cm or more than that.
ColorThe purpura is a purple reddish skin hemorrhage. 
             
Ecchymosis is the bluish or reddish discoloration on the skin and the area of ecchymosis changes from bluish or reddish to green or yellow, as the tissue heals. 
ShapePurpura is rounded skin discoloration, sometimes the bruises are flat or irregular in shape.
             
The shapes of ecchymosis are oval, rounded, or irregular. It may have a subcutaneous flat nodule at the center.
Cause Purpura can cause by a recent bone marrow transplant, hormone replacement, stem cell transplant, chemotherapy, estrogen therapy, and so on.
             
Ecchymosis is usually caused by an injury like a fall or blow, bump. Sometimes medications like antibiotics, blood thinners (warfarin, aspirin), corticosteroids, increase bleeding and make ecchymosis.
Treatment Different types of purpura need different treatments, most of the purpura is healed by taking drugs.
             
Most of the time it heals without any treatment if it is caused by an injury. In other cases, doctors may perform x-ray tests and MRI scans to identify the cause.

What is Purpura?

Purpura is identified by small purplish or reddish spots on the skin, usually 3-10 mm in diameter. It is also known as a blood clot or skin haemorrhage which can indicate several medical conditions, from minor injuries to life-threatening health issues. It occurs when blood vessels burst which causes blood to gather under the skin. 

The spots sometimes appear on mucous membranes, especially on the membranes on the mouth or any other organs. It causes a purple reddish spot on the skin which ranges from large patches to small dots. The purpura is a purple reddish skin haemorrhage. Purpura is rounded skin discolouration, sometimes the bruises are flat or irregular in shape. 

Unlike any other rashes, purpura will not blanch or change its colour when some pressure is given to the spot. Purpura can appear on skins anywhere on the body, including the membranes on the mouth. Purpura must not be avoided by the patients and also health professionals as purpura can be a symptom of a life-threatening disease. 

Purpura is more like symptoms of other health issues rather than a health condition. Purpura can cause by a recent bone marrow transplant, hormone replacement, stem cell transplant, chemotherapy, estrogen therapy, and so on. Different types of purpuras need different treatments, most of the purpura is healed by taking drugs. 

What is Ecchymosis?

The medical term for the common bruise is ecchymosis. It is the bluish or reddish discolouration on the skin that usually occurs due to an injury and measures one cm or more than one cm. It happens when blood leaks from the blood vessels and makes a blood pool into the nearby tissue under the skin. 

Ecchymosis is the bluish or reddish discolouration on the skin and the area of ecchymosis changes from bluish or reddish to green or yellow, as the tissue heals. The shapes of ecchymosis are oval, rounded, or irregular. It may have a subcutaneous flat nodule at the centre. 

Ecchymosis is usually caused by an injury like a fall or blow, bump. Sometimes medications like antibiotics, blood thinners (warfarin, aspirin), corticosteroids, increase bleeding and make ecchymosis. Several medical conditions like blood clotting disorders, cancer can cause ecchymosis. Lacking vitamin C and vitamin K can also cause ecchymosis. Kids tend to have ecchymosis during the sports season. 

Most of the time it heals without any treatment if it is caused by an injury. In other cases, doctors may perform x-ray tests and MRI scans to identify the causes. Doctors may prescribe a blood test if the ecchymosis is severe. The blood count and blood healing responses measured by the blood test can assist to diagnose the cause of ecchymosis.

Main Differences Between Purpura and Ecchymosis 

  1. Purpura is smaller in size than ecchymosis. It measures between 3-10 mm. On the other hand, ecchymosis is larger compared to purpura. It measures 1 cm or more than that. 
  2. The purpura is a purple reddish skin haemorrhage. Ecchymosis is the bluish or reddish discolouration on the skin and the area of ecchymosis changes from bluish or reddish to green or yellow, as the tissue heals. 
  3. Purpura is rounded skin discolouration, sometimes the bruises are flat or irregular in shape. The shapes of ecchymosis are oval, rounded, or irregular. It may have a subcutaneous flat nodule at the centre. 
  4. Purpura can be caused by a recent bone marrow transplant, hormone replacement, stem cell transplant, chemotherapy, estrogen therapy, and so on. Ecchymosis is usually caused by an injury like a fall or blow, bump. Sometimes medications like antibiotics, blood thinners (warfarin, aspirin), corticosteroids, increase bleeding and make ecchymosis.
  5. Different types of purpura need different treatments, most of the purpura is healed by taking drugs. On the contrary, most of the time it heals without any treatment if it is caused by an injury. In other cases, doctors may perform x-ray tests and MRI scans to identify the cause. 

Conclusion

Both purpura and ecchymosis indicate spontaneous bleeding under the surface of the skin. Both purpura and ecchymosis are more visible in the elderly and children as they have fragile microvasculature. These are more like symptoms of other health issues rather than health conditions. There are very few differences between purpura and ecchymosis.

The main difference between purpura and ecchymosis is that purpura is the small purple reddish discolouration on the skin and it does not blanch when external pressure is given over the spot. The discolouration spots generally measure between 3-10 mm. On the other hand, ecchymosis is the bluish or reddish discolouration on the skin and measures one than one cm.

References

  1. https://www.nejm.org/doi/full/10.1056/NEJMra010501
  2. https://europepmc.org/article/med/11149790
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