Appropriate Tests


Bruising is usually due to trauma and investigation should only be considered if the degree of bruising is disproportionate to the trauma or if the bruising is apparently spontaneous.

Exclude use of aspirin, other NSAIDs or possibly complementary medicine compounds: Where indicated, initial Full blood count, Prothrombin time, INR, APTT. If these are normal, and there is a low prior probability of underlying bleeding diathesis, no further investigation may be required.

Further investigation is guided by personal and family history. See Bleeding disorders for further information. Specialist input may be appropriate.

Unrecognised trauma, non-accidental injury


Elderly patients

Easy and extensive superficial bruising ('senile purpura') is typically seen over extensor surfaces of forearms, due to thin skin and fragility common in the elderly and in those who have experienced prolonged, excessive solar exposure - investigation is inappropriate.

Cushing's syndrome, including prolonged corticosteroid therapy


Vitamin C deficiency (Scurvy)




Connective tissue and collagen disorders:

Ehrlers-Danlos syndrome

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