In clinical practice, the ability to accurately describe skin findings is a fundamental skill for physical examination and diagnostic reasoning. When assessing the integumentary system, clinicians frequently encounter vascular lesions—abnormalities involving the blood vessels or the extravasation of blood into the skin tissues. These lesions can range from benign, age-related growths to critical indicators of systemic disease, such as liver dysfunction or coagulation disorders.
Understanding the nuances between different types of redness, bruising, and vessel dilation is essential for effective documentation and patient communication.
Hemorrhagic Lesions: Petechiae, Ecchymosis, and Hematoma
Hemorrhagic lesions occur when blood escapes from the vascular compartment into the surrounding tissue. While they may look similar to the untrained eye, they differ significantly in size, depth, and clinical implication.
Petechiae
Petechiae are described as small, pinpoint, nonblanching red or purple spots. The term "nonblanching" is a critical clinical descriptor; it means that when pressure is applied to the lesion (such as with a glass slide), the color does not fade or turn white. This indicates that the blood is actually outside the vessel (extravasated) rather than simply being a result of dilated vessels within the skin.
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