A 42-year-old woman undergoes a face lift. Two days later, she presents for follow-up care with confluent bluish hemorrhages in the skin around her eyes ("black eyes"). Which of the following best describes this pattern of superficial skin hemorrhage?
High-Yield Explanation
Ecchymosis is a larger superficial hemorrhage in the skin. Following hemorrhage, the initially purple discoloration of the skin turns green and then yellow before resolving. This sequence of events reflects the progressive oxidation of bilirubin released from the hemoglobin of degraded erythrocytes. A "black eye" is a good example of an ecchymosis. Petechiae (choice D) are pinpoint hemorrhages, usually in the skin or conjunctiva. Purpura (choice E) is a diffuse superficial hemorrhage in the skin up to 1 cm in diameter.Diagnosis: Ecchymosis