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What Causes Circular Bruise With A Pale Center?

Posted on Mon, 15 Sep 2014

Question: Hi have a circular (although not full circle) bruise with a paler center, I don't know how it happened, the bruise has got larger with some darker purple parts.
the center is just pale but i can't see a bite, and if i press on to the middle it hurts like a regular bruise
just wondering if this cud be a bite or just a bruise as I never had a circular bruise like this before.
I'm also starting to get a cold/fever symptoms, ie headache stiff neck etc but I was starting to get a cold before the bruise occured.

thanks

Answered by Dr. Shoaib Khan (6 hours later)

Brief Answer:
Need to rule out a few conditions sir

Detailed Answer:
Hello sir and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. You have not mentioned any medications in your medical history and you are quite young for me to suspect bleeding disorders, but due to the absence of any trauma or possible insect bite I will have to request you to visit a doctor to rule out a bleeding disorder sir.

If at all there was a positive history of trauma and/or an insect bite, drug use, etc; I wouldn't have asked you to visit a doctor. With the presence of clear borders and a circular bruise like appearance, strong suspicion of a bleeding disorder is present. I would recommend the following investigations sir:

-Complete blood count (haemoglobin/red blood cells, white blood cells, platelets, etc.)
-Coagulation profile
-Clotting factors
-Ultrasound of the affected region
-Physical examination

Please also let me know more about your family history and if you have observed that you bruise easy. Please also schedule an appointment with your doctor for the above mentioned investigations at your earliest convenience. Do not hesitate to write back to me for any further clarifications, I would be more than happy to help you.

Best of luck sir.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shoaib Khan (3 hours later)

Hi, i don't normally bruise easily and i don't recall any trauma, in fact i woke up and the bruise appeared.... its just that i can't see any bug bite so im not sure what it is.....
its not itchy or anything but the middle white part there is a slight lump, and when pressed it does ache like a bruise, i don't have any history of blood problems so I don't really think it is that,
could it be a insect bite but with a very very small bite that isn't visible to the eye?

thanks for your help

Answered by Dr. Shoaib Khan (27 minutes later)

Brief Answer:
Yes of course sir, it is possible

Detailed Answer:
Hello once again sir.

Of course it is still possible that it can be an insect-bite. Not all insect bites need to present with a bite sir, a general blood examination can tell if you are experiencing an allergic reaction or a reaction to an insect bite. The blood investigation will also at the same time rule out other conditions, so I think it would be wise to go ahead with it.

But in response to your query sir, yes it is surely possible that your presentation could be due to an insect bite. For now you could apply a topical solution containing steroids (like cortisone) and also try benadryl which should help with the inflammation. I hope you find my response helpful sir, please do not hesitate to write back to me for any further clarifications. I am always here to help.

Best wishes.

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar