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Dr. P. Jyoti
Dr. P. Jyoti , Doctor
Category: Pediatrics
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My 3 year old son has for the fourth time suffered a dark purple

Resolved Question:

My 3 year old son has for the fourth time suffered a dark purple discolouration on his ear lobe and on this final occasion he has also had a sore looking patch where his ear joins his head. This time it disappeared in 48 hours leaving a dry skin on back of his ear. I would like to establish the cause as I havent seen him injure the ear and he never complains about it.
On a couple of occasions it happened at the same time he had an ear infection. Are the two symptoms connected ?
Submitted: 4 years ago.
Category: Pediatrics
Expert:  Dr. P. Jyoti replied 4 years ago.
Hello,

I am an ENT specialist.

Does he have similar discoloration at times in his toes, fingers, lips, etc?

Is it on only one lobe or both sides at the same time?

How long do these patches last usually (though I understand it was 48 hours this time)?



Customer: replied 4 years ago.

 

Hello, no recolection of discoloration to his toes,fingers & lips.

Only one lobe at a time and lasts arround 48 -60 hours .

Expert:  Dr. P. Jyoti replied 4 years ago.
Hello,

There are a number of causes for this.

It is probably not linked to a ear infection as this would not cause a bluish discoloration in the ear lobe, also as you mentioned, it is not painful.

There are a number of causes that need to be looked into.

One cause which must be ruled out is inadequate oxygenation of blood. Ear lobes are among the first to show the purple signs of generalised inadequate oxygenation or cyanosis.

The causes which must be excluded for this include conditions like congenital heart disease, valve disease, methemoglobinemia, etc. This is something that you need to discuss with his pediatrician. I should reassure you that this is quite unlikely since he has no other symptoms, but this is something that must be excluded first. Hence you should consult his pediatrician and discuss about this, and also ask if it could be cyanosis.

The other important condition to rule out is Petechiae. Increased bleeding times could lead to the formation of small thromboses which may occur more commonly in the ear, this could also lead to such purple patches. This also needs to be excluded and should be discussed with his pediatrician.

The other more likely and less worrisome causes are:

Hypothermia - cold can cause this although it is usually temporary.

Bruising: you need to think about this also, whether someone, a slightly older child perhaps, might be pulling his ears.

Local cyanosis: finally the most likely cause. It is probably nothing more than him sleeping on ear and putting pressure on it at night and causing some bruising.

It probably means nothing to worry about, but as I said, you should consult his pediatrician and discuss about cyanosis and bleeding disorders.



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Customer: replied 4 years ago.

If it was bruising would it disappear that quickly?

Im sure that neither his big brother or anyone else has bruised his ear. He has not complained about any injury.

 

I am worrying, as my local hospital/police are investigating me as they think I have hurt his ear.

The Paediatrician I saw at the hospital had no indea why the discolouration disappeared soo quicly. Hence my reason for looking into it myself.

 

This time when he has had the colouration on the ear, he also had a swelling on the back of the head - is there any chance these could be connected? As the swelling went down in the same time period as the ear. Again the hospital/police think something has 'happened' to his head, but he never complained of an injury.

Expert:  Dr. P. Jyoti replied 4 years ago.
Yes, a bruise would come down in that period.

You should discuss about the conditions I mentioned with your pediatrician. Youu should ask for them to be ruled out.

There does not seem to be any connection between this purpe discoloration in the ear and a swelling at the back of the head. The only way they would be connected is through injury.



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Customer: replied 4 years ago.

Is there any reason why there would have been some dry and peeling skin left after the sore red patch (on his head where his ear joins it) disapperared?

 

While the mottled effect on his ear was the first to disappear, the final part of the discolouration was a more localised patch about 2cm x 1cm on the back of his lobe. Rather than being mottled purple, it was block colour purple - is there any explanation for this?

 

I'm wondering if there is any skin condition that could have caused the colouring on his ear?

 

I phoned the hospital and asked the Nurse to pass the information to the Pediatrician. The Nurse instantly said if it was inadequate oxygenation of blood then the ear would be blue rather than purple.

 

Thank you

Expert:  Dr. P. Jyoti replied 4 years ago.
The sore red patch would be consistent with bruising and not with the other causes.

Dermatological causes would not cause this.

There is no significance to being motted purple or block color purple.

Also, it is not a factor for diagnosis as to whether a color is to be called blue or purple, this is an entirely subjective choice of color names. A checkup is still necessary.


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Customer: replied 4 years ago.

Thank you for the information.

 

The medical report now says that my sons ear has been pinched, thats the reason for the bruising. However I know for sure that it has not been pinched.

 

If it was pinched, would the red sore patch be present?

 

 

Expert:  Dr. P. Jyoti replied 4 years ago.
Yes, the red sore patch in fact is a sign that there has been some trauma and hence it would be present.



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Customer: replied 4 years ago.
The red patch was on his head, not his ear.
There was also a dark purple solid patch on his ear.
Is there any possible explanation? Could he have pinched his ear himself?

The report also says his head must have had significant impact. But he never complained at actually doing anything to it neither had he complained since. Is there any way it could have happened without it hurting him?

Expert:  Dr. P. Jyoti replied 4 years ago.
No, there does not seem any other explanation other than that someone gave him a blow on the ear.

This is the most likely explanation.

If you have not done so yourself, you must look at who else could have done it.



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