Yep - got those from puking while pregnant. Some of the main causes of Petechiae are. -- By Holly C. Cold compress is also a very effective home remedy for petechiae as it causes constriction of the blood vessels and prevents bleeding from the capillaries. When you notice a wart on your finger, you might think of a few different things. Petechiae rashes may arise due to a number of factors. There are bacteria and other infections that can cause these petechiae to burst. My doctor said I has petechiae and they should usually go away in a couple days. Low INR Levels. When blood vessels in the skin break, blood leaks into the skin tissues, resulting in appearance of reddish spots on the skin. Angiokeratoma of Fordyce is usually diagnosed based on clinical examination of the lesion. It is defined as a small reddened lesions that measures one (1) to two (2) millimeters blotch that resulting to the bleeding of the surface of the skin and is usually affects the lower legs, shoulder. Get NCI’s Dictionary of Cancer Terms Widget. They look like little red dots and are most commonly found on the legs. 18 Likewise, viral symptoms are frequently found in children with petechial rashes. By Kathleen Megan, CTMirror. Petechiae are red due to the blood that has leaked out from the capillaries into the surrounding skin. It might be nothing to worry about, perhaps a harmless side effect of a medication for example but we can't assure you of that. Petechiae are tiny purple, red, or brown spots on the skin. Petechiae are not an uncommon finding in febrile children. or lower legs usually isn’t something to worry about. Not to worry about the marks, they are normal during exercises, especially around the shoulders. A lot of the time, a common problem is that baby gets too hot because we dress them too warmly, or wrap them up in blankets needlessly. He was thirteen months old and learning how to walk. It's hard having hypochondria but it's even harder to control it when you have a baby to worry about yes the doctor did say they were petechiae but that her cbcs and clotting factor all came back normal no anemia normal platelets wbc was 15. DA: 8 PA: 48 MOZ Rank: 37. Atopic Dermatitis and Primary Immunodeficiency: When Should I Worry? Markus Boos, MD PhD Attending Physician, Dermatology Seattle Children’s Hospital. Many tickborne diseases can have similar signs and symptoms. White oral lesions: How to distinguish the benign from the deadly. 7 Recognise that a capillary refill time of 3 seconds or longer is an intermediate-risk group marker for serious illness ('amber' sign). Petechiae is a sign of a disease related to low platelet count (thrombocytopenia). com today to learn more about Petechiae. I think I'm going to forego seeing my hematologist on Monday since I have an appointment with him in a week anyways, and this petechial rash isn't spreading. You don’t know how long it will be there, if it’s dangerous, or what it even is. Leukemia is a type of cancer that affects white blood cells. The bleeding causes the petechiae to appear red, brown or purple. Bruising in dogs is never normal, and signs of determine contusions (called petechiae) or larger bruises (ecchymosis) require an immediate journey to your veterinarian. the client with petechiae over the chest who's complaining of anxiety and shortness of breath The client who is complaining of anxiety and shortness of breath and has petechiae over his chest should be seen first. The rash of HSP may begin as erythematous macular or urticarial lesions, which progress to blanching papules and eventually to palpable purpura. He seemed 100% of his diagnosis, but this was the guy that originally thought my cancer was a sweat gland. A high dose of radiation is given to the tumour, but nearby healthy areas get much less. You may notice a petechiae rash on your legs, feet, arms, or upper body for a number of reasons. When to worry about worrying There is no shortage of things to worry about --- from personal concerns about job security or health, to fears related to larger issues such as political conflicts or natural disasters. Causes: Common causes are trauma to the eye, inherited or acquired bleeding disorders, therapy with blood thinners (such as warfarin) or severely elevated blood pressure. The rash starts out on the wrist and ankle as a maculopapular rash and then spreads and becomes petechial. They're tiny, pinpoint size red dots which don't fade when I press down on them. com today to learn more about Petechiae. They can be about the size of a pinprick but do not itch or blanch when you press on them. (See 'When to worry about bleeding' below. 18 Likewise, viral symptoms are frequently found in children with petechial rashes. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. 4mm to 1mm in diameter. The dots don't blanch (disappear) when you press on them. A rash is a reaction of the skin. Petechiae do not blanch out or become pale when pressure is applied. Applying excessive pressure could cause the body tissue to experience stress that causes the spots to appear. or lower legs usually isn’t something to worry about. Most of the time fevers are triggered by an infection. In all honesty, the management strategy varies from provider to provider, but what all pediatric hematologists will be most interested in is the physical exam details. Dec 21, 2018 · Shane McDaniel posted photos on Facebook of him and his twin sons surrounded by enough chopped wood to fill 80 standard-size pickup trucks. When is it time to worry about a child or adolescent with a petechial rash? Three potentially lethal yet treatable bacterial infections often produce a petechial rash: Staphylococcus aureus sepsis, meningococcal disease, and Rocky Mountain spotted fever, Dr. Petechiae may look like a rash, but they're actually due to bleeding under the skin. The authors report an unusual case of Rocky Mountain spotted fever that presented as an asymptomatic petechial eruption on the lower legs. They are also common on the lower legs, feet and ankles. What Is A Hematoma? A hematoma is a larger collection of blood, usually caused by surgery, injury, or a greater trauma. I have been super fatigued, and a 5 bruises on my legs that I am not sure where it came from. A petechia (pl. Nursing care plan/implementation: a. The few darker patches are new. Rashes and other skin. Petechiae result from capillaries bursting and bleeding into the skin, states Mayo Clinic. FindaTopDoc. When Hannah developed tiny red dots, called petechiae, on her body, her parents thought it might be a rash. since these can be really serious. Smoking is censer to the devil. Bruises are caused by the breakage of small veins and tiny blood vessels under the skin, causing red blood cells to leak. that my white blood cell count was slightly elevated, he asked me if i smoked or if i still feel fatigued and if at the time of doing my blood test if i had a cold or an infection. SkinVision's blog on skin cancer, melanoma, skin moles, and useful information for a healthy skin. As discussed above, Petechiae can be a sign of some underlying condition and should not be ignored. In general, seek immediate medical attention if your child has fever, breathing difficulties, or persistent vomiting in addition to the rash. 3 mm to 3 mm. Bruises on children: Dr Sam Hay says when you need to worry. Petechiae look like flat small red, brown, or purple spots on the skin. Cherry Angioma - What is it? Symptoms, Pictures, Causes, Prevention methods, Treatment, removal. In its final stages, petechiae spots turn dark blue or attain a dark purple appearance. 2012;52(4):301-307. Immune thrombocytopenia (ITP) is a fairly common blood disorder. Leukemia is a type of cancer that affects white blood cells. While biologic medications have revolutionized the treatment of many kinds of arthritis, like all drugs, in addition to their benefits, they come with new risks. On each painted nail there are 40 demons. Is Petechiae with normal cbc your major concern? Solve your problem quick & easy with online consultation. I am very worried due to me always linking petechiae with leukaemia Hello. Aug 18, 2017 · When should people worry about bruising? (iStock) By Consumer Reports •Ecchymoses or petechiae appear within a month of starting a new prescription or over-the-counter medication or supplement. As such process takes place in some areas blood vessels become visible or petechiae appear as a result of light pressure. _A yellowish tinting of the skin caused by excessive amounts of bile pigments—substances that are produced when the liver breaks down red blood cells — in the bloodstream. Leukemia begins in the immature or developing cells of the bone marrow, the soft, spongy tissue found in the central cavities of bones. Petechiae Information Including Symptoms, Diagnosis, Treatment, Causes, Videos, Forums, and local community support. That would take a visit to the doctor. Blereau, MD of Morgan City, La. The doctor said not to worry. Her only serious bleeding episode since we last spoke was in November and December of 2008. At my yearly OB appointment I showed the NP some tiny, pin head, red dots I have on my breasts and abdomen. Valid for Submission. Poisoning is typically more common during the winter months. _A yellowish tinting of the skin caused by excessive amounts of bile pigments—substances that are produced when the liver breaks down red blood cells — in the bloodstream. I had a left sided tonsillectomy the 24th for a tonsil cyst but that turned out to be a brachial cleft cyst. A healthy tongue is one that is pink in color, moist and is covered by a slightly thin coat on its surface. Cherry Angioma - What is it? Symptoms, Pictures, Causes, Prevention methods, Treatment, removal. This inflammation is called vasculitis. It almost cover my whole leg. It was only a couple of millimeters wide back then, but now it's 1. Take care and regards. It is estimated that 1 to 9 percent of people who do not show symptoms have elevated levels of liver enzymes. If the leaking blood invades skin tissue, it shows up as bruises, ranging from tiny reddish-brown or purple dots, called petechiae, to larger patches, referred to as purpura. Read this Medication Guide before you start taking. Petechiae on the legs, as well as on the other parts of the body, usually appear in clusters. What is Petechiae? Definition : When small blood vessels (capillaries) break under the skin, they cause reddish, brownish or purplish spots over the skin, which resemble rashes (3). I am 37 and now and then the spots come and go. Then I saw my breast surgen and he said it's just a bleed and it's called "Petechiae" And not to worry. Petechiae, When to Worry: Causes, Symptoms, and More healthline. confess I could not help sharing their worry despite Dr. This rash is called petechiae. The heart is a muscular organ with four chambers. Douglas Jones, this type of petechiae rash is common in cases of child abuse. How to Treat Pinpoint Petechiae. It can also occur if extreme pressure is applied to the tissues such as in excessive vomiting, tourniquet application or in too much coughing. My boyfriend actually noticed it first. White oral lesions: How to distinguish the benign from the deadly. The conjunctiva contains nerves and many small blood vessels. I lay in bed coming off of a parental high. Some malignancies can also cause petechiae to appear. Scattered petechiae with a fever are caused by Meningococcemia until proven otherwise. com Petechiae when to worry. Learn about five common problems and fixes. Unlike most pink rashes, petechiae don't fade when pressed on. Common accompanying symptoms of bright red (bloody) urine. These tiny red spots, formed due to capillary leak are called petechiae. these petechiae are ok. The bleed ins under my skin aren't that bad, they are worse on the arm where I messured my bp. Now that they have reappeared on my arm, I am feeling anxious. Upon looking at my right arm, I noticed a few there too. Medications Petechiae may result from taking some types of medications, including:. Spots also emerge as respond to some treatments. By providing false reassurance, the nurse actually cut off. They don't leave scars. The itching is the worst part of hot tub folliculitis. head can cause little blood vessels under the skin of the face and neck to rupture and form petechiae. Petechiae are red dots in the skin that do not disappear (do not blanch) when you appply pressure to them. The dots don't blanch (disappear) when you press on them. The petechiae was much bigger than the original mark. You can find these spots on your legs, stomach, arms or buttocks. Petechiae rashes may arise due to a number of factors. These blood spots are looks flat. Petechiae result from bleeding from small vessels which result either from a blood disorder, most commonly low platelet count, or a disorder of the blood vessels. 3 but they said for babies her age the norm is 6-17. It went away however a month ago it appeared again but bigger, I also gave many dots on my feet and legs. Psoriasis, which affects at least four million Americans, is slightly more common in women than in men. It can also occur if extreme pressure is applied to the tissues such as in excessive vomiting, tourniquet application or in too much coughing. Home Treatment for Petechiae. is it a suspected deep tissue injury (sDTI)? These terms are often used interchangeably, but within wound care, clinicians define them more precisely. They are harmless and you should not worry about them. During pregnancy there is a general downward drift in platelet count,particularly during the last trimester. Just remember that bruising in kids is completely normal; almost every child has them. When in confusion skin biopsy may be done to rule out other diseases. Symptoms of petechiae on legs. 4moosetracks wrote: My daughter has a total of 4-5 (one I’m not sure about) little blood spots that. The petechiae appear as discrete pinhead lesions in a 10-year-old boy, whereas they are manifested as minute hemorrhagic areas in a 30-year-old woman. When Hannah developed tiny red dots, called petechiae, on her body, her parents thought it might be a rash. Children who are well and have a clear history of a mechanical cause for their petechiae do not require investigation and may be discharged with review planned within 12 - 24 hours. I had petechiae on and off, started panicking but realised the spots only appeared when I scratched. If the petechiae appear in clusters, then they resemble a rash on the legs. This spot can be a symptom of many diverse conditions, some are serious, and some are minor. Basically, a minimum of 2 to 3 weeks is required for petechiae to heal and the affected individual can add another one week depending on the severity of the condition. How to Treat Pinpoint Petechiae. Or, if you have any question in your mind then you can ask here and get your answer. Just a few little dots on my right forearm. Here’s how to know what your mucus color means for your health. The good news is that this is a common rash that happens to otherwise healthy people and usually goes away on its own. A sudden appearance of tiny red dots on the skin is very common, happens with everyone, but still leaves you wondering what exactly the reason is behind the teeny tiny dots, is it something to worry about? They may be red, purple or brown spots on your skin, individually or in clusters, usually appearing on arms, legs, and face. Usually when cancer occurs in the family, either it occurs. Introduction. Most of the time fevers are triggered by an infection. I am very worried due to me always linking petechiae with leukaemia Hello. My doctor said I has petechiae and they should usually go away in a couple days. This is a life-threatening bacterial infection of the bloodstream. Presence of petechiae can be nothing to worry about or it might represent presence of a serious condition that needs medical attention. Purpura — Any of a group of disorders characterized by purplish or reddish brown area or spots of discoloration of the skin, ranging in size from pin-head to an inch or so in diameter, visible through the skin and caused by bleeding within underlying tissues with smaller bleeding points being sometimes called “petechiae” and larger darker. Petechiae spots form when tiny capillaries break and cause slight bleeding under the skin. If you notice any of the following, that is when to worry about a bruise and to immediately contact a health care provider: If you notice very small multiple bruises (also known as petechiae) without any injury you must contact your doctor urgently. Should well children with petechiae have blood tests? Petechiae in well babies occur commonly; a study published in 2002 found a prevalence of 27. If you haven’t been living under a rock lately, you’ve probably heard about the deadly Ebola virus being brought (willingly) on to American soil; so maybe it’s time to start. Unlike most pink rashes, petechiae don't fade when pressed on. This video has How to Treat Pinpoint Petechiae. Petechiae result from capillaries bursting and bleeding into the skin, states Mayo Clinic. Under this condition, these spots will increase as your platelets start to decrease. Doctors then focus on the nose, looking for the bleeding site. When you notice a wart on your finger, you might think of a few different things. It’s a lesson I learned the hard way. The patches look like dots of blood clot. I had a left sided tonsillectomy the 24th for a tonsil cyst but that turned out to be a brachial cleft cyst. Anyone know?. Petechiae are not an uncommon finding in febrile children. The red rash (which could lead to purple bruising) is only one of the symptoms of meningitis. I have another spot beginning on my other leg. When to Worry About Bruises By Courtney D. The small, pinpoint red dots on skin that may seem mere rashes can become a complicated medical. I used to get them when I had low platelets, but I had my platelets checked this time, and they are normal. If your breast implant pain returns or if it has been years since your surgery and you suddenly experience breast implant pain, make an appointment with your doctor to find out the source of your pain and find a solution. At first, those bumps may persist despite your best efforts. Symptoms may include petechiae, which are tiny red, brown, or purple spots on the skin that resemble a rash. Cervical Cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. com today to learn more about Petechiae. It can also occur if extreme pressure is applied to the tissues such as in excessive vomiting, tourniquet application or in too much coughing. +1 for added painkillers. In the book Hypothyroidism: The Unsuspected Illness thyroid pioneer Dr. Here, midwife and nurse, Jackie Hall, who leads our team of Health at Hand nurses gives you the lowdown on which spots to worry about. Usually flat to the touch, petechiae don't lose color when you press on them. DA: 22 PA: 100 MOZ Rank: 32. put my mind at ease for a while. They're tiny, pinpoint size red dots which don't fade when I press down on them. Increased the risk of suicidal thoughts and behaviors in children, adolescents and young adults taking antidepressants. The petechiae was much bigger than the original mark. Petechiae is a sign of a disease related to low platelet count (thrombocytopenia). Some medications can cause petechiae in adults. When a child has leukemia petechiae is a sign of a low platelet count. The spots themselves are tiny pinpricks that can be purple, red, or brown, which is due to the bleeding under the skin. They often occur in a cluster, giving the appearance of a rash. Most doctors consider blotches only as large as 3 or 4 mm for a diagnosis. The spots are flat and don’t itch or blanch (turn pale) when you press them. The symptoms of vasculitis depend on the particular blood vessels that are involved by the inflammatory process. Low INR Levels. Many of the red, pink, or brown spots you find on your skin are harmless, but some can signal serious skin issues or diseases. These spots usually have the color of purple, red or brown. "If in doubt check it out" is the general rule. What Are Petechiae? Petechiae can be described as marks or blotches that normally appear on the skin and are tiny, round, and purplish or reddish in color. Don't worry! These little hemorrhages will go away within a few days. Petechiae, When to Worry: Causes, Symptoms, and More healthline. When to Worry About Bruises By Courtney D. The first time my baby had a bad fall, I went into sheer panic mode. The petechiae I get are because I have low platelets. If you work out a lot, you might notice bruising in fatty areas that are exposed, like. Petechiae are not a cause of worry. Treatment of Angiokeratoma of the scrotum. Peak age is 3 to 6 months old. They are also common on the lower legs, feet and ankles. They look like little red dots and are most commonly found on the legs. Cradle cap can develop after the first month or two of your baby’s life. 10 - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more. I smoothed it evenly and took paper towels to rub off most from the back of my legs. It can also occur if extreme pressure is applied to the tissues such as in excessive vomiting, tourniquet application or in too much coughing. are called petechiae and appear when tiny blood vessels. Recurrent episodes of ITP can occur from time to time during childhood, but the severity of the condition usually becomes less, with time. Subacute endocarditis is more common in people with congenital heart disease. Spots also emerge as respond to some treatments. Christy update: December 2010. Petechiae on the legs. It does not blanch when pressure is applied on it. I have another spot beginning on my other leg. The authors report an unusual case of Rocky Mountain spotted fever that presented as an asymptomatic petechial eruption on the lower legs. A lot of the time, a common problem is that baby gets too hot because we dress them too warmly, or wrap them up in blankets needlessly. pinpoint red dots on skin - Petechiae. “Petechiae is small purple or red flat spots on the body caused by a minor hemorrhage. I'm so relieved my platelets are normal but am still curious what else might have caused the petechiae. The rash of HSP may begin as erythematous macular or urticarial lesions, which progress to blanching papules and eventually to palpable purpura. In your son's case, as long as the counts are above 100,000/ cmm, and he is symptomatically stable, there is no need for any major interventions. The rash starts out on the wrist and ankle as a maculopapular rash and then spreads and becomes petechial. 4mm to 1mm in diameter. Patients get febrile and toxic. If your INR is within range, you shouldn't have much to worry about, I'd think. It can also occur if extreme pressure is applied to the tissues such as in excessive vomiting, tourniquet application or in too much coughing. When in confusion skin biopsy may be done to rule out other diseases. So, if you have this eyelid issue then do not worry just try the treatments mentioned here. While the spots themselves don't hurt or itch, all of my skin's been really itchy for the past week or so due to what I think is an allergic reaction to either dust mites or my. According to the National Center on Elder Abuse (NCEA), the term “elder abuse” refers to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable older adult. Not just a couple, but I had a lot. (See 'When to worry about bleeding' below. PETECHIAE FOUND ANYWHERE ELSE ON THE BODY BESIDES THE FACE AND NECK COULD BE A SIGN OF A. Basically I was wondering if anyone else has this problem that seems to be all over my body. Minor hemorrhage (bleeding that is localized below the skin) is the source of petechiae. Under this condition, these spots will increase as your platelets start to decrease. They are also common on the lower legs, feet and ankles. Symptoms of gonorrhea may vary depending on the organ infected. head can cause little blood vessels under the skin of the face and neck to rupture and form petechiae. the doctor did not seem to be concerned. The size of the rash ranges from 0. com in Home , Meaty Meals , Therapeutic Posts and Parenting 1 Comment Sunday morning the older boys woke up and went directly downstairs to play their precious video games. Just a few little dots on my right forearm. You can speed up your healing by leaving the rash alone and staying out of the infected hot tub. Low INR Levels. To me it seems very obvious that it's petechiae, and iof you google it (don't, it's scary!) it says it's basically caused by low platelet levels from things like leukaemia, cirrhosis, lupus (already been tested for that one), aplastic anaemia etc. Our family also has connective tissue disorder (some have Hypermobile Ehlers Danlos and some Hypermobility Spectrum Disorder) and apparenlty this can cause leaky veins due to over stretchy tissue. Trauma is considered the main cause of petechiae spots on legs or other parts of body. There are 24 conditions associated with night sweats and skin rash. Master your assignments with step-by-step solutions to countless homework questions asked and answered by our members. In the book Hypothyroidism: The Unsuspected Illness thyroid pioneer Dr. The cause of Petechiae on the legs is often bleeding or hemorrhage, which lends the color to these spots, such as reddish, brownish or purple in color. When it first appears, a bruise will be reddish looking, reflecting the color of the blood in the skin. What is Petechiae? The term Petechia is often referred to as "ecchymoses or skin spots" a common problem that affects capillary blood vessels. Trauma - Petechia spots arise more frequently due to trauma on the skin than any other reason. Subacute endocarditis is more common in people with congenital heart disease. There are a few precautions you can take before your next beach trip to help prevent this occurrence, and there are also a few solutions to help your body post-trip to keep. Soothe the Itch. Another thing is that I have these bug bites all over my legs, however when I scratch them they heal normally, and I know with Leukemia that doesnt happen or whatever. Petechiae (say "puh-TEE-kee-eye"): Are tiny, flat red or purple spots in the skin or the lining of the mouth. ABSTRACT: Chronic irritation from smoking is the most common cause of white mucosal lesions. Learn about Petechiae. Kind of freaking out over petechiae spots. These spots can also appear […]. Still, it's always a good idea to check with your doctor if you're not sure where these spots came from. Tightly wrapping compression bandage around a part of the. Confused? Don’t worry, we’re here to help!. The few darker patches are new. Our neighboor was just diganosied with chronic leukima at 39. Neck nodes may be enlarged. However, these patients should use caution and consume marijuana under the guidance of an experienced healthcare provider. Finding a strange spot on your body can be pretty scary. Doctors Lounge - Dermatology Answers Back to Dermatology Answers List. Not just a couple, but I had a lot. Rashes and other skin. Petechiae are usually pinpoint-sized. It also causes frequent, urgent and painful urination. How to Treat Pinpoint Petechiae. Unless there is a definite alternative explanation for the petechiae, the child should be treated with parenteral antibiotics until blood cultures return as negative at 48 hours (it is important to establish whether the child has already been on oral antibiotics). Symptoms of gonorrhea may vary depending on the organ infected. The bleeding causes the petechiae to appear red, brown or purple. Petechiae often look like a rash, which can be alarming. When it first appears, a bruise will be reddish looking, reflecting the color of the blood in the skin. DA: 95 PA: 48 MOZ Rank: 42. Petechiae are small purple or red spots on the skin that occur due to damage to blood capillaries underneath the skin — capillaries are the ending of blood vessels that form a microscopic meshwork so oxygen. Its symptoms affect your thought processes, feelings, behaviors, and all of your body parts. This affects the amount of urine. I am 37 and now and then the spots come and go. It was only a couple of millimeters wide back then, but now it's 1. Small, red, flat spots present on the skin often indicate petechiae. , the peeling tongue problem. Question: I am on my feet all day at work but I have recently noticed that around 5 p. 6% of a cohort of 116 babies less than twelve months of age at child health surveillance clinics, predominantly to the trunk and lower limbs. A petechia (pl. Low platelet count, also know as thrombocytopenia, can be caused by cancer itself, radiation and chemotherapy. When they first develop, they may be only a tenth of a millimeter in diameter and almost flat, appearing as small red dots. Usually it is of 0. The bleeding causes the petechiae to appear red, brown or purple. Petechiae are not a cause of worry. If ignored, the cause of Petechiae could lead to serious medical complications for your child. Petechiae is a sign of a disease related to low platelet count (thrombocytopenia). Red spots also known as Petechiae or blood spots on skin. It can also occur if extreme pressure is applied to the tissues such as in excessive vomiting, tourniquet application or in too much coughing. Angiokeratoma of Fordyce is usually diagnosed based on clinical examination of the lesion. If these are really petechiae, you would want to rule out low platelets due to cancer or autoimmune disorders, etc. Tiny, pinpoint hemorrhages can be seen in the skin and are referred to as petechiae. Viral infection will generally run their course over 4-5 days. …can be subdivided based on size into petechiae and ecchymoses.