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Child has scattered bruise on lip. Diagnosed with bruise. What treatment should be done?

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My daughter picked up my granddaughter (3 yrs) from daycare today. Her upper lip, and lower lip all the way to her chin is dark and blotchy like a scattered bruise. The daycare personnel, who are typically very diligent, had no explanation other than a possible "allergy" although her diet today contained nothing new. My daughter took her to the doctor who just diagnosed it as a bruise. There's no major swelling, just the scattered bruising which runs almost in a straight line from her lips to her chin. She doesn't complain of soreness, isn't saying anything hit her or that she fell (she would have wailed if she fell to a hit that hard). What follow up questions would you ask the daycare tomorrow? And, would you suggest any treatment tonight?
Posted Fri, 15 Mar 2013 in Skin Hair and Nails
 
 
Answered by Dr. Rakhi Tayal 12 minutes later
Hello,
Thanks for posting your query.
It seems that the bruise on her face has appeared spontaneously. You need ask the daycare attendant regarding any contact with wild plants or flowers, any pushing or injury to the area, any fight among the children, etc.
You need to self monitor the area for any spread of the bruise and examine her thoroughly to find out bruises at any other place on her body.
Easy or spontaneous bruising can be for many causes such as
- Platelet disorders of counts like thrombocytopenia,
- Disorders of function like Glanzman syndrome where platelets are lazy i.e. normal in number but slow to clumping and degranulation.
- Deranged Prothrombin time (PT) /activated Partial Thromboplastin time (aPTT) secondary to many causes
- And lax and fragile skin secondary to treatment with steroids.
So I believe getting her blood counts along with Capillary fragility test can be helpful to detect bleeding tendency.
Discuss about these possibilities with her treating physician and he/she can stream line these test for her. She also may be put on Vitamin C and good health.
Regards.
Dr. Rakhi Tayal.
Above answer was peer-reviewed by
 
Follow-up: Child has scattered bruise on lip. Diagnosed with bruise. What treatment should be done? 23 hours later
No followup question, just a thank you to Dr. Tayal. Your wise and well-researched reply was very much appreciated.
It turns out, my granddaughter had removed the lid from her drinking cup, brought it to her mouth, and sucked the air from it. In essence, she gave herself a "hickey" on her mouth and chin. Now her mother will be experienced when she had grandchildren on day!
 
 
Answered by Dr. Rakhi Tayal 4 hours later
Hello.
You are welcome.
Please keep me informed regarding the progress.
You can consult me again directly through my profile URL http://bit.ly/Dr-Rakhi-Tayal
Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.
I wish your granddaughter an early trouble free recovery.
Above answer was peer-reviewed by
 
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