Definition of bleeding manifestations based on physical examination
| Site of bleeding . | Manifestation . | Definition . |
|---|---|---|
| Skin (epidermis and dermis) | ||
| Petechiae | Red (recent) or purplish (a few days old) discoloration in the skin with a diameter of 0.5-3 mm that does not blanche with pressure and is not palpable | |
| Ecchymosis (purpuric macule, bruises, or contusions) | Flat, rounded, or irregular red, blue, purplish, or yellowish green patch, larger than a petechia. Elevation indicated spreading of an underlying hematoma into the superficial layers of the skin | |
| Skin (subcutaneous tissue) | ||
| Hematoma | Bulging localized accumulation of blood, often with discoloration of overlying skin | |
| Visible mucous membranes | ||
| Petechiae, purpuric macules, and ecchymosis | Same as for skin | |
| Bulla, vesicle, and blister | Visible raised, thin-walled, circumscribed lesion containing blood. Each bulla (>5 mm) is larger than a vesicle. Bullae, vesicles, and blisters should be counted together as bulla | |
| Epistaxis | Any bleeding from the nose may be anterior or posterior and unilateral or bilateral | |
| Gingival bleeding | Any bleeding from the gingival margins | |
| Subconjunctival hemorrhage | Bright red discoloration underneath the conjunctiva at onset; may assume the appearance of an ecchymosis over time | |
| Muscles and soft tissues | ||
| Hematoma | Any localized collection of blood visible, palpable, or revealed by imaging. May dissect through fascial planes |
| Site of bleeding . | Manifestation . | Definition . |
|---|---|---|
| Skin (epidermis and dermis) | ||
| Petechiae | Red (recent) or purplish (a few days old) discoloration in the skin with a diameter of 0.5-3 mm that does not blanche with pressure and is not palpable | |
| Ecchymosis (purpuric macule, bruises, or contusions) | Flat, rounded, or irregular red, blue, purplish, or yellowish green patch, larger than a petechia. Elevation indicated spreading of an underlying hematoma into the superficial layers of the skin | |
| Skin (subcutaneous tissue) | ||
| Hematoma | Bulging localized accumulation of blood, often with discoloration of overlying skin | |
| Visible mucous membranes | ||
| Petechiae, purpuric macules, and ecchymosis | Same as for skin | |
| Bulla, vesicle, and blister | Visible raised, thin-walled, circumscribed lesion containing blood. Each bulla (>5 mm) is larger than a vesicle. Bullae, vesicles, and blisters should be counted together as bulla | |
| Epistaxis | Any bleeding from the nose may be anterior or posterior and unilateral or bilateral | |
| Gingival bleeding | Any bleeding from the gingival margins | |
| Subconjunctival hemorrhage | Bright red discoloration underneath the conjunctiva at onset; may assume the appearance of an ecchymosis over time | |
| Muscles and soft tissues | ||
| Hematoma | Any localized collection of blood visible, palpable, or revealed by imaging. May dissect through fascial planes |