Persistent Bruise on Foot: When to See a Specialist?

Bruise not fading?

Hello doctor, I suddenly noticed a small round green bruise on the top of my foot one day.
I initially thought it was just from pressure, so I didn't pay much attention to it.
However, it has been over a month now, and the bruise has become a raised purple mark with a greenish hue around it, and it doesn't seem to be improving.
Should I see a hematologist for this?

Kait, 20~29 year old female. Ask Date: 2018/02/07

Dr. He Dongjin reply Cardiology

Hello, you can continue to observe your condition, and if you have any concerns, you may visit the hematology department for further consultation.
Changhua Hospital cares about you.

Reply Date: 2018/02/07

More Info

When dealing with a persistent bruise on the foot, especially one that has changed in color and texture over time, it's important to take the situation seriously. A bruise, or contusion, typically occurs when small blood vessels break under the skin due to trauma, leading to bleeding and discoloration. However, if a bruise persists for more than a few weeks, changes in appearance, or becomes painful, it may indicate an underlying issue that requires further evaluation.

In your case, the fact that the bruise has been present for over a month and has evolved into a raised, purple area with a greenish hue is concerning. While bruises can take time to heal, especially if the area continues to be used or if there is ongoing trauma, the characteristics you describe suggest that it may not be healing as expected. This could be due to several factors, including:
1. Underlying Vascular Issues: Sometimes, persistent bruising can be a sign of vascular problems, such as venous insufficiency or other circulatory issues. If blood flow is compromised, it can lead to prolonged bruising.

2. Coagulation Disorders: If you have a condition that affects your blood's ability to clot, such as thrombocytopenia (low platelet count) or other hematological disorders, this could lead to easy bruising and prolonged healing times.
3. Infection: Although less common, a bruise can become infected, especially if there was an open wound associated with the bruise. Signs of infection include increased redness, warmth, swelling, and pain.

4. Other Medical Conditions: Certain conditions, such as liver disease or vitamin deficiencies (like Vitamin K), can also lead to easy bruising and delayed healing.

Given these possibilities, it would be prudent to consult a healthcare professional. While a hematologist (blood specialist) could be appropriate if you suspect a blood disorder, starting with a visit to a primary care physician or a specialist in orthopedics or sports medicine might be beneficial. They can perform a physical examination, take a detailed history, and possibly order blood tests or imaging studies to determine the cause of the persistent bruise.

In the meantime, here are some general recommendations for managing a bruise:
- Rest and Elevation: Avoid putting weight on the affected foot and elevate it to reduce swelling.

- Cold Compress: Applying a cold compress can help reduce swelling and numb the area, which may alleviate discomfort.

- Pain Management: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help manage pain and inflammation.

- Monitor Symptoms: Keep an eye on the bruise for any changes, such as increased size, pain, or signs of infection.

In conclusion, while bruises are common and often harmless, a persistent bruise that changes in appearance warrants further investigation. Seeking medical advice will help ensure that any underlying issues are addressed promptly, allowing for appropriate treatment and peace of mind.

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