• The two black arrows point to subcutaneous accumulations of blood.

• An ecchymosis is a collection of blood greater than 1 cM in sizeoutside the vascular tree, and within tissue .

•Trauma or bleeding/clotting disorder

•As a result of trauma, blood escapes from the vascular tree and accumulates in the tissues.

•Common

•The trauma causing the lesion is of greater significance than the ecchymosis itself.

•The same is true if the patient is developing these lesions with no obvious trauma.

•Ecchymosis is an area of hemorrhage into the skin and subcutaneous tissue >1 cm in diameter.

•An ecchymosis is often the result of injury; however, clotting and bleeding disorders can predispose to the formation of an ecchymosis.

•Grossly, an ecchymosis presents as a bluish lesion at the earliest stages of onset.

•As the red blood cells in the lesion undergo progressive degeneration and the hemoglobin becomes converted through bilirubin into hemosiderin, the lesion progressively changes color from blue through green through purple to finally a brownish discoloration.

•Histologically, the lesion is characterized by the presence of red blood cells lying outside of capillaries.

•With time there is infiltration by inflammatory cells, primarily macrophages in which hemosiderin deposition can be seen several weeks to months after initial lesion.

•Ecchymosis has no clinical significance other than a cosmetic appearance, especially when it occurs around the face, in particular the orbit, where it is referred to as a "black eye."

• Current literature from PubMed at National Library of Medicine