Generality
The bruises on the legs are a sign that results from a superficial blood spill, which is deposited in the thickness of the skin of the lower limbs.
This blood extravasation manifests itself as a visible, purplish-red, relatively large patch that does not disappear under pressure. The bruises on the legs are typically associated with local pain, swelling, tingling and numbness in the affected area, sometimes followed by annoying tension. On the basis of the etiology, then, other disorders can occur, such as, for example, itching and a sense of heat.
In most cases, the bruises on the legs are due to trauma and shock . However, this symptom can manifest itself spontaneously or with great ease, apparently without any precise cause . The bruises on the legs can be found, in fact, in the context of pathologies and pharmacological therapies that determine an excessive fragility of the vessel wall, alter the coagulation capacity and reduce the number of platelets.
The characteristics of the bruises on the legs and the appearance in relation to other symptoms are important aspects for the differential diagnosis. Therefore, if these signs are recurrent or persist more than necessary, it is important to seek medical attention for appropriate clinical investigations.
What are
The bruises on the legs are an expression of a bleeding that occurs in the layer next to the surface of the skin .
The appearance of these purplish-red signs derives from a condition limited only to the lower limbs (eg trauma or wound that has not damaged the skin, abnormality of the blood vessels, etc.) or a pathology that involves the whole organism (blood diseases, neoplasms, liver diseases, etc.).
In other words, the medical significance of bruising on the legs can range from minor events to life-threatening illnesses .
Bruises, Hematomas, Ecchymoses and Petechiae
The bruises on the legs can be divided - in order of size - into petechiae and ecchymoses . If there is also a visible and palpable swelling, one speaks instead of hematoma .
Causes and Risk Factors
The bruises on the legs can be the symptom of a series of events and pathologies of different entity and nature.
What do the bruises on the legs depend on?
The bruises on the legs are almost always caused by accidental bumps and traumas (such as bruises, fractures or dislocations). However, this symptom may also appear suddenly, apparently without reason.
The bruises on the legs may depend, in fact, on a local problem (ie limited to the lower limbs) or systemic pathologies that make them more prone to the formation of such signs.
Some factors that can influence the greater tendency to show bruising in the lower limbs are:
- Type of skin and thickness of skin tissue (the bruises on the legs are more evident on very light and thin skin);
- Aging (with age, capillaries become more fragile, therefore more prone to breakage);
- Taking certain drugs that tend to thin the blood, such as aspirin;
- Blood pressure surges caused by physical exertion .
traumas
The most common cause of bruising on the legs is definitely a trauma suffered directly in the area where the reddish-purple patch will form.
These signs arise when a bump or a direct lesion occurs (such as, for example, a fall or a hammer blow ) and the under-skin tissue, together with the muscle fibers, is crushed .
In practice, the bruises on the legs occur when the skin does not undergo a tear, but the capillaries located below the skin tissue are damaged and the blood inside them pours, remaining trapped in the layer near the surface.
Other possible causes
The bruises on the legs can arise spontaneously or with great ease in the context of morbid conditions that:
- Reduce the number of platelets ( thrombocytopenia ), as in the case of:
- Hemolytic-uremic syndrome;
- Sepsis;
- HIV infections.
- Alter the coagulation capacity of the blood :
- Haemophilia;
- Leukemia;
- Systemic lupus erythematosus;
- Amyloidosis;
- Some myelodysplastic syndromes;
- Liver disease (eg liver cirrhosis);
- Disseminated intravascular coagulation;
- Vitamin K deficiency
The bruises on the legs can signal the presence of pathologies that determine an excessive fragility of the vessel wall, as happens, for example, in purple (simple or senile) and scurvy.
The bruises on the legs can be found in the presence of:
- Acute pancreatitis;
- Aplastic anemia;
- Various infectious diseases (eg meningococcal septicemia).
Other conditions that may predispose to bruising on the legs include:
- vascular;
- Connective tissue diseases, including:
- Ehlers-Danlos syndrome;
- Imperfect osteogenesis;
- Marfan syndrome;
- Inflammatory disorders of small vessels (eg phlebitis).
Bruising on the Legs from reaction to drugs
Some medicines can cause or facilitate bruising on the legs. These include, in particular, anticoagulants (such as warfarin and heparin), antiplatelet agents and anti-inflammatories (eg aspirin and corticosteroids). When this adverse effect develops, it is advisable to consult your doctor to remodulate or correct the treatment protocol.
Symptoms and Complications
The bruises on the legs appear as a visible, purplish-red, relatively large patch that does not disappear under pressure. As the days pass, the color of the lesion changes from purplish to green or yellow, until it resolves completely within 15-20 days, when blood infiltration is reabsorbed.
This chromatic variation depends on the modifications of the hemoglobin contained in the erythrocytes (red in color) which, in the absence of pulmonary oxygenation, turns first into methaemoglobin, then into hematin (green-brownish) and, subsequently, in hemosiderin (green-yellowish) and hematoidin (yellow).
Bruises on the legs: how do they manifest themselves?
The symptoms with which the bruises appear on the legs can vary mainly depending on their cause, especially if it is a bump or a trauma. At times, the sign may even form in an area distant from the one that suffered the injury, since the blood that spills can migrate.
In addition to the obvious red-purple extravasation of blood, the bruises on the legs are typically associated with the following manifestations:
- Pain, a sense of tension and local swelling ;
- Stinging and numbness in the affected area.
Fortunately, the bruises on the legs are not permanent and spontaneously regress within a few days.
Possible associated disorders
Depending on the underlying cause, bruising on the legs can be associated with numerous other signs and symptoms, such as:
- Itch;
- Burning sensation;
- Hypersensitivity;
- flaking;
- Scab formation.
The systemic manifestations associated with the appearance of the bruises on the legs are very variable. Depending on the cause causing it, for example, there may be general malaise, joint pain, fever, stomach ache, weight loss, weakness, palpitations and headache.
The clinical features of the bruises on the legs and the appearance in relation to other symptoms are important aspects for the differential diagnosis.
Diagnosis
To ascertain whether the bruises on the legs are related to specific pathological conditions, it is advisable to consult your general practitioner. The procedure to establish the exact triggering cause requires, first of all, the collection of anamnestic data and the physical examination .
When to seek medical attention urgently
In general, the doctor should be consulted when the bruise on the leg persists and does not heal within two weeks. However, it is advisable to go immediately to the emergency room if a strong sense of pressure is perceived in the area where the impact was suffered with associated tingling and / or loss of sensitivity.
Furthermore, it is advisable to contact the doctor when the knee joint cannot be moved or the bruises on the legs:
- They are formed with extreme ease (even in the absence of a precise cause, at least apparently);
- They cause severe pain or start to swell;
- Signs of an infection appear.
Leg bruises: which exams are needed?
When the bruises on the legs are accompanied by other manifestations of significant importance (eg fever, dyspnea, headache, etc.) and the etiology is still uncertain, the doctor can indicate the performance of laboratory and instrumental tests.
These tests include:
- Complete blood count : identifies quantitative changes in blood cells and possible thrombocytopenia;
- Peripheral smear: examination of a microscopic blood sample to check for blood cell damage, abnormalities or immaturity;
- Prothrombin time (PT) and partial thromboplastin time (PTT), which measure the activity of coagulation factors;
- Erythrocyte sedimentation rate (ESR), PCR and other inflammation rates;
- Thyroid, hepatic and renal function tests;
- Dosage of tumor markers.
Should an anomaly emerge from one of the diagnostic investigations, further investigations are generally necessary to establish the causes of the bruises on the legs, confirming or excluding the various clinical suspects.
Treatment and Remedies
The treatment of bruises on the legs varies depending on the cause that is responsible for them. Normally, these signs tend to resolve spontaneously within a few days, but some remedies can be used to speed up the healing process.
Remedies
- After a trauma, to reduce the size of the bruises on the legs, the pain and the swelling, it is useful to apply directly on the part of the cold packs, wrapping some ice cubes in a towel or a cloth to protect the skin, being careful to respect the intervals of about fifteen minutes. Even the natural active ingredients with anti-edema and anti-inflammatory action (such as arnica, bromelain, horse chestnut, pineapple and escin) can be useful in these cases.
- At the same time, it is also advisable to limit the efforts at the level of the lower limbs, so as not to aggravate the situation. When you lie down on the sofa or bed, to facilitate the flow of blood to the legs where the bruises have formed, thus speeding up their healing, it may be useful to lift them, placing a pillow under them.
- To avoid absolutely is instead, the emptying of the bruise (for example, trying to puncture it with a needle), since it would not accelerate the resolution of the payment.
- To counteract the predisposition to breaking the capillaries and the easy appearance of the bruises on the legs it is important to take care of the diet, limiting the salt, drinking a lot of water and consuming substances rich in flavonoids, such as wild berries and grapes, which reinforce the capillaries.
Bruising on the legs: what can be done to reduce the pain associated with them?
- In the event that these signs are caused by a trauma or a temporary disorder, generally, it is not necessary to undertake any kind of treatment, as they will gradually resolve within a few days.
- In the most serious cases, to mitigate the bruises on the legs, the doctor can indicate pharmacological treatments based on analgesic or anti-inflammatory creams .
- If the bruises on the legs are caused by a specific basic pathology, the treatment of the latter can induce the resolution of the symptomatology. Unfortunately, this does not always occur and, in some cases, these signs tend to appear even if the disease that triggered them has been adequately treated.
