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Samwel Mikaye: Petechiae, Purpura, and Ecchymosis – A Clinical Guide to Skin Bleeding
Dr. S.0 MIKAYE / LinkedIn
Apr 17, 2026, 15:37

Samwel Mikaye: Petechiae, Purpura, and Ecchymosis – A Clinical Guide to Skin Bleeding

Samwel Mikaye, Medical Doctor at MSK, shared a post on LinkedIn:

“These three terms describe types of bleeding into the skin or mucous membranes.

They mainly differ by size of the bleeding spots.

1. Petechiae

Definition: Tiny pinpoint red or purple spots caused by small capillary bleeding.

  • Size: less than 2 mm
  • Appearance: flat, non-blanching (do NOT fade on pressure)
  • Cause: capillary leakage or platelet problems

Common causes

  • Low platelets (thrombocytopenia)
  • Infections (e.g. meningococcemia)
  • Straining (vomiting, coughing)

2. Purpura

Definition: Larger purple/red spots due to bleeding under the skin.

  • Size: 2–10 mm
  • Appearance: flat, non-blanching
  • More visible than petechiae

Common causes

  • Platelet disorders
  • Vasculitis (blood vessel inflammation)
  • Blood clotting disorders

3. Ecchymosis

Definition: Large bruise caused by bleeding into deeper skin tissues.

  • Size: more than 1 cm
  • Appearance: bluish, purple, then green/yellow as it heals
  • Commonly called a bruise

Common causes

  • Trauma (most common)
  • Blood thinners (e.g. warfarin)
  • Bleeding disorders
  • Liver disease

Petechiae are pinpoint (tiny dots)

Purpura are purple patches (medium size)

Ecchymosis is an extensive bruise (large)

Clinical importance

These signs may indicate:

  • Low platelets
  • Serious infections (especially petechiae with fever)
  • Bleeding disorders”

Samwel Mikaye: Petechiae, Purpura, and Ecchymosis - A Clinical Guide to Skin Bleeding

Other posts featuring Samwel Mikaye on Hemostasis Today.

bleeding disorders bleeding spots Dermatology Ecchymosis Health Hematology Hemostasis Hemostasis News Hemostasis Today Medicine Petechiae Purpura Samwel Mikaye Skin Bleeding thrombosis
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