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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 5604
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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On my forearm I have what seems yo a bruise . the color changes

Customer Question

On my forearm I have what seems yo a bruise . the color changes from red to a purpulish color and the surface is hard . the pain varies sometimes when I use my arm a lot it hurts for hours others days it doesn't bother at all
JA: OK. The Doctor will need to help you with this. Is there anything else the Doctor should be aware of?
Customer: I am diabetic and have high blood pressure
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Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 1 year ago.
Hi,Im sorry to hear about your symptoms. Well there are a couple of things which need to be considered here. The first thing to know is that whether this developed after any sort of trauma if that is the case, then you probably have developed a hematoma. This is a collection of blood underneath the skin which may be inside the muscle as well. This would be diagnosed on a simple clinical examination and then usually is treated with application of heat and /or ice. This can also be treated with painkillers and application of compression bandages in some cases. Now if there is no history of trauma, this would be more concerning because this would mean that you have spontaneous bleeding which can be due to a number of underlying conditions. This could be a problem with the platelets, which arethe small cells which form blood clots or it could be a problem with the coagulation system. now there a number of diseases which can cause this problem. The best way to determine if this is the case would be to get a simple CBC done as well as a PT/APTT/INR test done as well. if you could post a picture of the bruisethat would be helpful. Secondly, in order to be more exact i would need more information such as do you have bleeding from other sites, any other symptoms like fever, muscles aches and pain, rashes, your past medical history and any medications that you might be on. If you would like to continue this conversation please let me know. Do you have any more questions?If you are satisfied, Please leave a POSITIVE rating by clicking on the stars below, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating.
Customer: replied 1 year ago.
I've have this for about 9 months it started like a dime size bruise and now its just expanded to my elbow. No other bleedings . I'm a diabetic and have high blood pressure. I have attached a picture
Expert:  Dr. Muneeb Ali replied 1 year ago.
Thank you for the additional information. Well this does seem like that you have subcutaneous or rather bleeding in the deep tissues of the arm, especially if the color changes to a purplish hue. Now as to what can be the cause, that would have to be determined by getting the tests i mentioned above done first of all. It is possible that you have an underlying bleeding disorder. This could be something like idiopathic thrombocytopenic purpura in which there is a drop in the platelet count however i would first consider nutritional deficiencies like vitamin B12, K, D deficiencies. This could also be the result of another autoimmune disorder like the ITP i mentioned above or even one of the other numerous conditions which are a part of autoimmune disorders. The most important thing here is that the bruise is expanding and does not seem to be settling on its own, anytime a spontaneous bruise appears on your body, it HAS to be evaluated by your healthcare provider. A CBC and PT/APTT/INR test HAS to be done under all circumstances. This can then be followed by more specific tests like ESR, ANA depending on the results of the initial tests. Usually bleeding spontaneously isnt associated with diabetes per se but injuries can fail to heal properly with uncontrolled diabetes, if this was more brownish in color i would consider acanthosis nigricans which is associated with diabetes. But since it isnt, i would STRONGLY recommend that you have the above tests done as soon as possible. One more possibility can be senile purpura if your age is above 60-65, that occurs due to fragility of the skin and blood vessels due to exposure to the sun. This usually doesnt need specific treatment. So in short i would recommend that you get the above tests done and contact your doctor for a definitive diagnosis. Do this as soon as you can. Do you have any more questions?If you are satisfied, Please leave a POSITIVE rating by clicking on the stars below, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating.
Expert:  Dr. Muneeb Ali replied 1 year ago.
Do you have any more questions?If you are satisfied, Please leave a POSITIVE rating by clicking on the stars below, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating.
Expert:  Dr. Muneeb Ali replied 1 year ago.
Do you have any more questions?If you are satisfied, Please leave a POSITIVE rating by clicking on the stars below, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating.
Expert:  Dr. Muneeb Ali replied 1 year ago.
Do you have any more questions?If you are satisfied, Please leave a POSITIVE rating by clicking on the stars below, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating.

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