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Dark purple swollen skin patch on hand, history of breast cancer, taking drugs for blood pressure & antidepressants. Possible bleeding disorder?

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66, 5'7", 110 lbs (barely), history of breast cancer (past her 5 year clear XXXXXXX & doing well); on statin drugs, blood pressure meds & antidepressants. She noticed a dark purple, swollen area on her forearm just above the wrist/thumb area. It is better now (not as discolored; but that vein is still quite pronounced up & down her forearm...unless she keeps her arm in the air (forgot to mention yes, smoker & frequent beer consumption) marked pain (just sore and worrisome to her).
She's wondering if I should take her to the ER or if she should just call her Dr. in the AM. Please advise? I don't want to waste a trip....but don't want to ignore something serious & kill my Mom!
Posted Thu, 26 Apr 2012 in General Health
Answered by Dr. Rakhi Tayal 13 minutes later

Thanks for writing to us.

An appearance of a dark purple swollen area in the forearm spontaneously without any history of injury is most probably suggestive of a Bleeding disorder. In this case, history of prolonged intake of Aspirin needs to be ruled out. Your mother needs to consult her physician to get a complete blood coagulation profile checked with APTT and platelet count to rule out other possible causes like Thrombocytopenia.

This can also happen due to a viral infection in the recent past- decreases the synthesis of platelets from the bone marrow.

Presence of any autoimmune disorders also needs to be ruled out.

The treatment is based on the diagnosis and severity of the problem. Treatment is usually done by stopping Aspirin, fluid infusion, steroids, immunoglobulins, blood transfusions, etc according to the severity of the condition.

Right now you need to monitor the lesion- if it is extending, immediately go to an ER other wise you can wait till the morning if her vital signs like pulse, BP and respiration are stable.

Meanwhile apply a cold compress by wrapping ice cubes in a towel to decrease active bleeding and also the inflammation.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.

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