Brief Answer:
Go for bleeding time and clotting time with APTT

Detailed Answer:
Hello young fellow,

Welcome again to the forum and thanks for posting your query to forum.

I can understand your concern for contusions as shown in the picture. Let me first reassure you that the picture does not show the contusion at present and rather are simple marks which are known as Post-inflammatory marks.

Let me first guide you for the contusions or the problem of bruises which we call medically as "purpuric or ecchymotic spots" is common condition seen due to multiple causes.

In your case it might be a normal phenomenon due to mild trauma of skin which is known as " Traumatic Purpura" or can be due to certain other factors involved.

To guide you elaborately- Bruise or the purpura is simply formed due to extravasation and collection of red blood cells from the vessels under the skin. This results in formation of reddish spots which we call as Bruise in simple language.

There are multiple of factors causing extravasation of red blood cells from the vessels-

1. Due to trauma to the small blood vessels of the skin.

2. Due to some problem in the platelets ( the cells which prevents the extravasation of red blood cells from the vessels and forms the clot).

3. Due to problem with the coagulation factors which helps in repair of the injury to blood vessels and helps in clot formation.

4. Due to combination of all these factors.

So you can probably get simply the factors involved in the contusions. Now as I mentioned previously that in your case it can be normal phenomenon or can be due to certain other problems which you have mentioned in your medical history.

For the best part of the diagnosis and differentiate between normal "simple Purpura" or purpura due to any abnormal cause there are simple blood tests of routine functions and platelet function and coagulation factors. These tests are:

- Bleeding time ( BT)
- Clotting time (CT)
- Activated partial thromboplastin time (APTT) test
- Platelet counts

These are done routinely in all the laboratories to rule out the exact cause of the problem. If these tests are normal then you can rest assured and relieve your tensions regarding the bruises. Otherwise also if the tests are abnormal then a physician reference is required.

In my patients of your kind of problem I prefer to do these above tests to rule out any internal cause of the problem.

In your case I can see that your reports are totally normal and just clotting time and bleeding time are lacking. I suggest you to go for bleeding time and clotting time with Activated partial thromboplastin time (APTT) test and report to me.

- In my patients with purpura I prefer Vitamin C as first line therapy. Vitamin C is required for the synthesis of collagen, an important structural component of blood vessels and therefore for the strength of blood vessels and prevention of spots. Along with Vitamin C tablets I suggest my patients to consume a lot of Citrus fruits like oranges, guava and lemon juice.

I suggest you to please go for the tests first and tell me the results so that accordingly guidance and treatment can be taken.

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health and early recovery from the problem"

Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology & STDs)

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Brief Answer:
Take Vitamin C tablets two times daily.

Detailed Answer:
My dear young buddy,

Welcome again to the forum and thanks for all your appreciation. I am really happy to know that you are relaxed to know the simple nature of the problem.

If I were your treating dermatologist then would have first gone for the policy of wait and watch. It means to observe whether there is recurrence of lesion in further few weeks. If the lesions recurs then would have gone for the tests as enumerated in previous mail. So you can just wait and watch at this time and just relax.

Till that time I would have suggested to take Vitamin C tablets. It generally comes in strength of 500mg containing Ascorbic acid (active biochemical of vitamin C). I prefer to give it two times a day. This can be chewed or can be taken with water any time after meals. These tablets are available at all the pharmacies as over the counter (OTC) medicine and you do not require any prescription for the same.

Do not forget to take good amount of sour fruits daily. DO not worry about the mild spots which are simple pigmentation spots now and do not show any activity. So just relax about the spots and will take its own time to regress.
I hope this information will help you. If you have further queries I will be happy to help.
With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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Brief Answer:
weekly D3dose formulation is more patient friendly

Detailed Answer:
Hello young buddy,

Thanks a lot for your swift follow up. I really appreciate your friend's caring gesture and agree with him to take Vitamin D3 additionally.

You can take effervescent tablets contain calcium lactate-gluconate ( 1 g ) + calcium carbonate ( 0.327 g ) + ascorbic acid ( 1 g ) for the vitamin C. As it contains 1 g of ascorbic acid, so one time a day is sufficient.

For Vitamin D3 I suggest an advanced tablet to be taken once a week only rather than daily formulation. Some of the times I have seen that Vitamin D3 on daily doses causes bit nausea and abdominal discomfort. So this weekly dose formulation is more patient friendly and do not cause any such problems. I suggest you to ask your friend for the same.

Convey my thanks to him for helping you!!!

I hope this information will help you. If you have further queries I will be happy to help.
With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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Brief Answer:
Best wishes for good health

Detailed Answer:
Hello young buddy,

So sweet of you for all the admiration. I with you today and always for helping out in all your dermatological issues.

My all best wishes for good health of you and and your family.

If you have further queries I will be happy to help or if not then can close the discussion and rate the answer.

Keep in touch!!!

With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases

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