Merck Manual

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Purpura Simplex

(Easy Bruising)


David J. Kuter

, MD, DPhil, Harvard Medical School

Reviewed/Revised May 2023

Purpura simplex is increased bruising that results from vascular fragility.

Purpura refers to purplish cutaneous or mucosal lesions caused by hemorrhage. Small lesions (< 2 mm) are termed petechiae, and large lesions are termed ecchymoses or bruises.

Purpura simplex is extremely common. The cause and mechanism are unknown. Purpura simplex may represent a heterogeneous group of disorders or merely a variation of normal.

The risk of purpura simplex may increase in patients who have

  • Treatment with aspirin or oral anticoagulants (eg, warfarin)

  • A low body weight

  • Prior exposure to corticosteroids

  • Sun exposure

The disorder usually affects women.

Bruises develop on the thighs, buttocks, and upper arms in people without known trauma. The history usually reveals no other abnormal bleeding, but easy bruising may be present in family members. Serious bleeding does not occur.

The platelet count and tests of platelet function, blood coagulation, and fibrinolysis are normal.

All patients should be evaluated for the possibility of physical abuse.

No drug prevents the bruising, and no treatment is needed. Patients are often advised to avoid aspirin and aspirin-containing medications. Patients should be reassured that the condition is not serious.

Drugs Mentioned In This Article

Drug Name Select Trade
Anacin Adult Low Strength, Aspergum, Aspir-Low, Aspirtab , Aspir-Trin , Bayer Advanced Aspirin, Bayer Aspirin, Bayer Aspirin Extra Strength, Bayer Aspirin Plus, Bayer Aspirin Regimen, Bayer Children's Aspirin, Bayer Extra Strength, Bayer Extra Strength Plus, Bayer Genuine Aspirin, Bayer Low Dose Aspirin Regimen, Bayer Womens Aspirin , BeneHealth Aspirin, Bufferin, Bufferin Extra Strength, Bufferin Low Dose, DURLAZA, Easprin , Ecotrin, Ecotrin Low Strength, Genacote, Halfprin, MiniPrin, St. Joseph Adult Low Strength, St. Joseph Aspirin, VAZALORE, Zero Order Release Aspirin, ZORprin
Coumadin, Jantoven
NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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