An ecchymosis (pl. ecchymoses) is a subcutaneous spot of bleeding with diameter larger than 1 centimetre (0.39 in)[1]. It is similar to (and sometimes indistinguishable from) a hematoma, commonly called a bruise, though the terms are not interchangeable in careful usage.[2] Specifically, bruises are caused by trauma whereas ecchymoses, which are the same as the spots of purpura except larger, are not necessarily caused by trauma,[3] often being caused by pathophysiologic cell function, and some diseases such as Marburg virus disease.

Bilateral periorbital ecchymosis, also known as "raccoon eyes". (Bruising around the eyes on both sides.)

A broader definition of ecchymosis[4][5] is the escape of blood into the tissues from ruptured blood vessels. The term also applies to the subcutaneous discoloration resulting from seepage of blood within the contused tissue.

Signs and symptoms

Hematomas can be subdivided by size. By definition, ecchymoses are 1 centimetres in size or larger, and are therefore larger than petechiae (less than 3 millimetres in diameter)[1] or purpura (3 to 10 millimetres in diameter)[6]. Ecchymoses also have a more diffuse border than other purpura.[7]


There are many causes of subcutaneous hematomas including ecchymoses. Coagulopathies such as Hemophilia A may cause ecchymosis formation in children.[8] The medication betamethasone can have the adverse effect of causing ecchymosis.[9]

Etymology and pronunciation

The word ecchymosis (/ˌɛkɪˈmsɪs/; plural ecchymoses, /ˌɛkɪˈmss/), comes to English from New Latin, based on Greek ἐκχύμωσις ekchymōsis, from ἐκχυμοῦσθαι ekchymousthai "to extravasate blood", from ἐκ- ek- (elided to ἐ- e-) and χυμός chymos "juice".[10] Compare enchyma, "tissue infused with organic juice"; elaboration from chyme, the formative juice of tissues.

See also


  1. Robbins basic pathology. Kumar, Vinay, 1944-, Abbas, Abul K.,, Aster, Jon C.,, Perkins, James A., (10th ed.). Philadelphia, Pennsylvania. p. 101. ISBN 9780323353175. OCLC 960844656.CS1 maint: extra punctuation (link) CS1 maint: others (link)
  2. "UCSF Purpura Module" (PDF). Archived from the original (PDF) on 2013-10-02. Retrieved 2013-01-13.
  3. "Easy Bruising Symptoms".
  4. Merriam-Webster Dictionary.; accessed 1/2/2012
  5. Gould, George M. The Practitioner's Medical Dictionary, P. Blakiston's Son & Co., 1916 et seq.; p. 311
  6. McKenzie, Shirlyn B., (2014). Clinical Laboratory Hematology. Williams, Joanne Lynne, 1949-, Landis-Piwowar, Kristin, (3rd ed.). Boston. p. 665. ISBN 9780133076011. OCLC 878098857.CS1 maint: extra punctuation (link) CS1 maint: multiple names: authors list (link)
  7. "Case Based Pediatrics Chapter". Retrieved 2009-01-08.
  8. Lee, AC (June 2008). "Bruises, blood coagulation tests and the battered child syndrome" (PDF). Singapore Medical Journal. 49 (6): 445–449. PMID 18581014.
  9. "betamethasone" (PDF). F.A. Davis.
  10. Merriam-Webster, Merriam-Webster's Collegiate Dictionary: "ecchymosis", Merriam-Webster.
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