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Anticoagulants

Large bruises that occur with minimal trauma or spontaneously as a direct result of medications that thin the blood.

Coagulopathy

Widespread ecchymoses resulting from an inherited or acquired defect in blood clotting factors, such as hemophilia or liver disease.

Corticosteroids

Long-term steroid use leads to fragile blood vessels, causing characteristic flat, irregular, purple bruises on the forearms and hands with minimal trauma.

Disseminated intravascular coagulation

A life-threatening condition presenting with widespread ecchymoses and hemorrhagic necrosis due to systemic activation of coagulation.

Ehlers Danlos syndrome

A connective tissue disorder characterized by hyperextensible skin and easy, extensive bruising due to blood vessel fragility.

Heparin necrosis

A rare reaction to heparin causing well-demarcated, painful, hemorrhagic plaques that progress to necrosis, often at injection sites.

Purpura fulminans

A catastrophic condition of DIC and skin necrosis, presenting as large, rapidly spreading areas of hemorrhagic necrosis.

Scurvy

Vitamin C deficiency leading to impaired collagen synthesis, characterized by perifollicular hemorrhage (bleeding around hair follicles), corkscrew hairs, and ecchymoses.

Systemic amyloidosis

Deposition of amyloid in blood vessel walls causes fragility, leading to characteristic "pinch purpura" or spontaneous periorbital ecchymoses ("raccoon eyes").

Warfarin necrosis

A rare complication of warfarin therapy, presenting as painful, hemorrhagic skin lesions that progress to necrosis, typically on fatty areas like the breasts or thighs.

von Willebrand disease

The most common inherited bleeding disorder, causing easy bruising, nosebleeds, and prolonged bleeding after procedures.

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