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”
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