Which Medical Specialty Should You See for Unexplained Bruising?

Which specialty should I see?

I have been experiencing unexplained bruising on both of my legs lately, without any trauma.
It has been going on for a while.
Which specialist should I see: Rheumatology, Hematology, or Dermatology? Also, is there any connection between the bruising and my abdominal pain, as well as discomfort in my lower back? I have a history of chronic lower back pain.

Sen Sen, 10~19 year old female. Ask Date: 2012/08/30

Dr. Liao Yaopan reply Family Medicine

Hello, based on your description, it is recommended that you consult your family physician for a personal examination first.
Depending on the situation, appropriate referrals can be made.
Thank you for your message, and Changhua Hospital cares about you.

Reply Date: 2012/08/30

More Info

If you are experiencing unexplained bruising on your legs without any known trauma, it is essential to consult a medical professional to determine the underlying cause. In this case, the most appropriate specialty to see would be Hematology (Blood Disorders). Hematologists specialize in blood-related conditions, including issues that may lead to easy bruising, such as clotting disorders, platelet dysfunction, or other hematological abnormalities.

Unexplained bruising can occur for various reasons, including:
1. Platelet Disorders: Conditions like thrombocytopenia (low platelet count) can lead to easy bruising. This can be due to bone marrow disorders, autoimmune diseases, or certain medications that affect platelet production.

2. Clotting Factor Deficiencies: Conditions such as hemophilia or von Willebrand disease can cause excessive bleeding and bruising due to deficiencies in specific clotting factors.

3. Vascular Issues: Some vascular conditions can lead to fragile blood vessels that may rupture easily, causing bruising.

4. Medications: Certain medications, such as anticoagulants (blood thinners) or corticosteroids, can increase the risk of bruising.

5. Nutritional Deficiencies: Deficiencies in vitamins, particularly Vitamin C (scurvy) or Vitamin K, can lead to increased bruising.

Given your mention of chronic back pain, it is also worth noting that some conditions affecting the spine or surrounding tissues can lead to referred pain or discomfort in the back, but they are unlikely to be directly related to the bruising unless there is an underlying systemic issue affecting both areas.
If you are also experiencing abdominal pain alongside the bruising, it is crucial to mention this to your healthcare provider, as it could indicate a more systemic issue that needs to be evaluated. Conditions such as liver disease, which can affect clotting factors and lead to both bruising and abdominal discomfort, should be ruled out.

In summary, while you might consider seeing a rheumatologist for autoimmune conditions or a dermatologist for skin-related issues, the best initial step would be to consult a hematologist. They can perform the necessary blood tests to evaluate your platelet count, clotting factors, and overall blood health. Depending on their findings, they may refer you to other specialists if needed.

When you visit the hematologist, be prepared to discuss your symptoms in detail, including the duration and frequency of the bruising, any medications you are currently taking, and any other symptoms you may be experiencing, such as abdominal pain or changes in your back pain. This information will help the doctor make a more accurate diagnosis and develop an appropriate treatment plan.

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