![]() ![]() Although there are many causes of bruising in children, none of them appear as uniform as in association with coining. Usually the lesions are not regularly spaced and there is a history of exposure to the chemical, which is found in many citrus fruits. The affected areas may take the appearance of a hand (if a hand, with lime juice on it, touches the child and transferred the juice to the skin of the child) or there can be driplike marks caused by the juice dripping down the patient's body. This disorder results in gray-brown staining of the skin, which sometimes is mistaken for bruising. Lastly, phytophotodermatitis is caused by an interaction of a photosensitizing chemical and ultraviolet light. All sexually active teenagers with these lesions should be tested for syphilis. Secondary syphilis can also mimic pityriasis rosea with quite dramatic papulosquamous lesions. Occasionally the condition is intensely pruritic, and the patient may make many scratches that could resemble coining, although these excoriations don't generally look like the lines of petechiae characteristic of coining. Although somewhat symmetric, the lesions are not uniformly spaced. Symptoms may affect your face, trunk (torso), and extremities and include: papules (small raised bumps on skin) and nodules (lumps under the skin) that typically feel firm or rubbery. The patches follow the skin lines of the back and are aligned in diagonal rows like Christmas tree branches. Pityriasis rosea consists of round and oval patches of salmon-colored lesions with a peripheral ring of scale. Other skin conditions are found on the back, but these are not predominantly petechial in their presentation. In all of these bleeding disorders, the petechiae or bruising should be seen in other areas in addition to the back. Bruising or purpura can also be seen in many different coagulopathies. Petechiae can be seen in various bleeding disorders involving low or abnormal platelet numbers. There are several differential diagnostic possibilities to consider in this case. The clinician might also inquire as to why or how these marks came to be placed on the patient's back. Therefore, if the examiner is sure the lesions are petechiae, the next question to ask is what could have caused such carefully placed lesions. Bruises caused by inflicted trauma would usually be randomly distributed and often would involve more than one part of the body. The symmetric, linear pattern of petechiae on the back is classic for coining. He was able to talk about the dangers of drug misuse in the context of the lifethreatening event he had experienced. This episode was used to discuss with the patient his mother's concerns regarding his drug use. The young man was reluctant to discuss this incident because he was embarrassed by his mother's use of a technique that he considered archaic and un-American. She had attempted to improve his breathing, using a method that is common in her country of origin, when she found him unconscious after an episode of illicit drug use. When the practice of coining (rubbing the skin firmly with the edge of a coin) was described to him, he admitted that his mother had engaged in coining him about 4 days previously. Women bruise more easily than men, especially from minor injuries on the. ![]() Initially, he claimed to have no idea about their cause. What causes random bruising on thighs WebWhen blood vessels break, bruising occurs. The blood vessels are held more securely in men and their dense collagen layer is thicker. Easier bruising in women is caused by women’s skin being thinner and because the fat and blood vessels in our skin are arranged differently to men. Are there any other explanations for these marks?ĪNSWER: The patient had symmetric linear groupings of petechiae on his back but at no other site. Women bruise easier than men, esp legs & buttocks. The possibility that he was a victim of child abuse was suspected after he claimed to have no knowledge of the cause of the bruising. 2, 2023.QUESTION: A 17-year-old Vietnamese boy being admitted to a juvenile detection facility had linear, bruise-like lesions on his back. National Heart, Lung, and Blood Institute.Centers for Disease Control and Prevention. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. The acutely ill patient with fever and rash. Morphology of primary and secondary skin lesions. In: Dermatology: An Illustrated Colour Text. In: Taylor and Kelly's Dermatology for Skin of Color. In: Clinical Dermatology: Diagnosis and Management of Common Disorders. Purpura and disorders of microvascular occlusion. Skin in the area may also be sensitive to touch and reddish in color. ![]() Dermatologic manifestations and complications of COVID-19. If your lower leg or thigh feels this way, it could be due to a blood clot called deep vein thrombosis (DVT). ![]()
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