Spontaneous Bruising : Triage Questionnaire

Spontaneous bruising in adults can arise from a variety of underlying conditions, necessitating a comprehensive approach to diagnosis and management. Initial evaluation should focus on identifying potential hematologic disorders, medication effects, and underlying systemic diseases.

One of the primary considerations in adults presenting with spontaneous bruising is the possibility of hematologic disorders such as thrombocytopenia or coagulopathy. For instance, idiopathic thrombocytopenic purpura (ITP) is characterized by persistently low platelet counts, which significantly increases the risk of spontaneous bruising and other bleeding manifestations (Enger et al., 2010). Similarly, von Willebrand disease (VWD) is another hematological condition that can lead to easy bruising, particularly in cases where there is a deficiency in von Willebrand factor (Echahdi et al., 2017). The clinical presentation of VWD often includes mucocutaneous bleeding, such as easy bruising and epistaxis, which can vary in severity depending on the residual activity of the von Willebrand factor (Rashid et al., 2020).

In addition to hematologic causes, medication use can also contribute to spontaneous bruising. The concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and certain antidepressants, such as citalopram, has been associated with increased bruising incidents due to their effects on platelet function and coagulation pathways (Desilets et...