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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33535
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have two apple size bruises on my thighs. They are painless

Customer Question

I have two apple size bruises on my thighs. They are painless and have appeared out of nowhere.
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 5 years ago.

Since when are the bruises?
Are you on any medications, herbs, supplements?
Any significant past medical history or family history?

Dr. Arun
Customer: replied 5 years ago.
I think I have had them three to four days. I take prestiq and adderall. My father has diabetes.
Expert:  Dr. Arun Phophalia replied 5 years ago.

The most common cause of bruises is minor capillary break. There is no specific cause for it, is a self resolving phenomenon and is not worrisome. This is termed as Ecchymoses (bruise). This usually develop with or without noticeable trauma and do not spread into deeper tissues. This can occur due to the structural abnormalities of the small blood vessels called as capillaries, which break even with the slightest of the injury. This can occur due to the scurvy (vitamin C deficiency), steroid-induced purpura, small vessel vasculitis, and purpura associated with the presence of paraproteins. Aspirin or other pain medications may also be responsible which can increase the bleeding time. The diagnosis is based on the investigations. Though, with the possible exception of a prolonged bleeding time, screening tests are usually normal in patients with bleeding disorders related to vascular abnormalities (ecchymoses / bruising). Investigations are only advised, if this occur recurrently / frequently. Taking Vitamin C or eating citrus fruits or fresh juices may help.


The investigations done are;


1) platelet count,

2) bleeding time (BT),

3) prothrombin time (PT),

4) activated partial thromboplastin time (aPTT),

5) thrombin time (TT)

6) peripheral blood smear,

7) platelet aggregation in response to ADP, epinephrine, collagen, and ristocetin;

8) platelet release assays,

9) coagulation factor assays,

10) assessment of factor XIII activity via clot solubility testing

11) Tests of fibrinolysis; measurement of fibrin split products and D-dimer levels.


Your PCP can get them done. An initial screening can be done by the first 5 or 6 tests which would give very definitive clue to the diagnosis, but as we discussed are done when phenomenon is frequent.


Please feel free for your follow up questions.


I would be happy to assist you further, if you need any more information.


Dr. Arun
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33535
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 3 other Health Specialists are ready to help you
Customer: replied 5 years ago.
I also have been getting quarter size bruises on the backs of my upper arms with no cause. This has been happening for a least a month.
Expert:  Dr. Arun Phophalia replied 5 years ago.

Since they have started suddenly, a blood work should be done. This may give clue to cause. Meanwhile you may start vitamin C, which would be helpful

It is privilege assisting you.

Dr. Arun
Customer: replied 5 years ago.
Relist: Answer quality.
Expert:  Dr. Sohaib replied 5 years ago.

Welcome to Just Answer...

I agree with you previous experts answer which carries all the necessary details....

For a spontaneous bruising, a work up should be done including CBC, BT, PT,APTT etc, which can lead the physician towards a specific underlying diagnosis...

You should see an internist, and if deemed necessary, he can refer you to a hematologist for further evaluation...

Many a times, these bruises occur due to trauma which is not remembered, but its imperative to get this evaluated...

Kindest Regards...

Customer: replied 5 years ago.
Does leukemia have to run in your family to get it. I am going to see my dr to get blood work done. I've read up on everything it could be possible related to. Also if I haven't changed my dite what would the odds be of this being a vitamin deficiency
Expert:  Dr. Sohaib replied 5 years ago.

Well, any disease which alters the normal blood (leading to reduction in numbers, abnormality in fuctions of blood cells), that include benign conditions as well as malignant conditions (like blood cancers such as leukaemia) can give rise to bruises...

But a bruise is usually not the only symptom of leukaemia...

One also gets features of anemia (easy fatigueability), active bleeding from nose, rectum or in urine, infections etc...A patient with leukaemia is very sick usually, not satable in general with no other symptoms except a bruise...

I think the exact answer will come from some simple blood tests and will ease your stress...

Kindest Regards and Goodluck...