The colors of ITP

Hi everybody,

this looks like a stupid question, but of which color are your bruises?

When I am low on platelets (<20K) I may develop some rare bruises when I am accidentally hit by something. I have never had petechiae though, not even at 5K. I have noticed that my bruises are from the very beginning of a brownish/yellow color instead of the red/blue one would expect.

Last year I was hospitalized when I was at 2K and got several ivig infusions. They did many attempts to search for a good vein (the flow at some point would stop getting into the vein and would instead make my arms swollen). When I was discharged from the hospital my both arms were full of the classical red bruises.

I was wondering if one can learn something from the color of the bruises, like the presence of specific substances in one's blood at that time etc...

Regards,
Carl

I always associated the color of the bruise with the severity of it, meaning the amount of bleeding under the skin. I have had very large, black-purple bruises which I considered to be more serious than the little yellow ones.

Everyone is different and has different symptoms. Less significant bruising is good. I don't think you can tell by the bruises what substances are in the blood? The substances should not change except for the number of platelets, but that doesn't always indicate what colors they should be.

Hi Sandi,

thanks for the quick answer. My curiosity was also triggered by the following text from Wikipedia (entry "bruise" and section the mechanism of a bruise):
"....During this time, larger bruises may change color due to the breakdown of hemoglobin from within escaped red blood cells in the extracellular space. The striking colors of a bruise are caused by the Phagocytosis and sequential degradation of hemoglobin to biliverdin to bilirubin to hemosiderin, with hemoglobin itself producing a red-blue color, biliverdin producing a green color, bilirubin producing a yellow color, and hemosiderin producing a golden-brown color."

My bruises are yellow or golden-brown from the beginning which seems to suggest that hemoglobin is degraded pretty quickly. In fact the text from Wikipedia suggests a correlation between color and substances.

I think that is just part of the healing process. If your hemoglobin levels are normal, there shouldn't be anything to worry about.

I found an in-depth discussion of the colors of bruises with respect to healing in a textbook on trauma my library happened to have. I also noticed that ITP bruises don't necessarily follow the textbook pattern for blunt trauma that causes bruising. In ITP, we can bruise from the inside out, whereas most bruises are due to blunt force acting from the outside in. This can affect which colors show up where and how they evolve.

As Sandi said, if lab work such as hemoglobin is normal, there's no need for concern.

ITP bruises generally don't hurt either. That was one way I could tell the difference between an ITP bruise and a bump bruise. If it didn't hurt, it was spontaneous. They sure looked like they would hurt!

So true. A friend watched one day as an ITP bruise formed on my hand. She kept asking if it hurt, and I kept telling her it was nothing. She took a lot of convincing.