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Side Effect: Bleeding into the Skin (petechiae, purpura, ecchymosis)

What is Bleeding into the Skin (petechiae, purpura, ecchymosis)?

Petechiae, purpura, and ecchymosis are all terms used to describe different types of bleeding into the skin. These symptoms occur when tiny blood vessels (capillaries) burst or have a small tear and allow red blood cells to leak out into the surrounding tissue.

What does Bleeding into the Skin (petechiae, purpura, ecchymosis) look like?

Petechiae, purpura, and ecchymosis appear as red or purple spots on the skin and do not blanch (become faint, or turn a lighter color like a rash may when touched) when pressure is applied.

External bleeding does not happen with any of these types of minor blood loss unless the skin breaks open and releases the trapped red blood cells.

Bleeding into the Skin (petechiae, purpura, ecchymosis)

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Who gets Bleeding into the Skin (petechiae, purpura, ecchymosis)?

Older adults are also more prone to developing petechiae and purpura due to age-related changes in blood vessels making them more fragile. In addition, as we age, we lose collagen in our skin which helps to protect blood vessels and allows them to move more freely without breaking.

Ecchymosis, which is a slightly larger form of red blood leaking into skin, can be caused by trauma (such as bumping into something hard), or due to underlying medical conditions, such as bleeding disorders or liver disease.

How to prevent Bleeding into the Skin (petechiae, purpura, ecchymosis)

Preventing petechiae, purpura, and ecchymosis largely depends on addressing the underlying cause. For example, people with bleeding disorders may need to avoid certain medications or take medications to help control bleeding. Treating infections promptly and avoiding trauma or injury to the skin can also help prevent these conditions. Patients with low platelets may need to receive platelet transfusions to help prevent all types of bleeding, especially if the platelet count reaches very low levels (for example, platelets less than 10,000/µL).

How to treat Bleeding into the Skin (petechiae, purpura, ecchymosis)

Treatment of petechiae, purpura, and ecchymosis in patients with cancer depends on the underlying cause and severity of the condition.


1) Pereira J and Phan T. Management of bleeding in patients with advanced cancer. Oncologist 2004;9:561-570.

Created: March 12, 2024 Updated: March 12, 2024