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1

Comabella, M., F. Titus, and P. Huguet. "Recurrent Paroxysmal Headache Associated with Facial Ecchymosis." Cephalalgia 16, no. 5 (August 1996): 341–43. http://dx.doi.org/10.1046/j.1468-2982.1996.1605341.x.

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The case of a 58-year-old man with chronic paroxysmal headache and facial ecchymosis is described. The headache was pulsating, of short duration without nausea or vomiting, and occasionally associated with flashing lights. Ecchymoses were mainly located in the middle forehead region and their appearance was associated with a reduction in intensity of the headache. Blood coagulation tests were within normal limits, and a skin biopsy of the ecchymotic lesior ruled out an underlying vasculitis. These attacks were difficult to include in any particular type of headache, although some aspects were similar to migraine headache. The possible mechanism of hemorrhages it discussed.
2

Sahan, Ebru, and Muhammed Emin Boylu. "METHYLPHENIDATE INDUCED ECCHYMOSIS." Psychiatria Danubina 33, no. 1 (April 14, 2021): 65–66. http://dx.doi.org/10.24869/psyd.2021.65.

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3

Alaghband, Pouya, and Vernon Long. "Periorbital Ecchymosis." Journal of Pediatrics 168 (January 2016): 245–245. http://dx.doi.org/10.1016/j.jpeds.2015.09.058.

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4

Kakisaka, Yosuke, Mayu Fujikawa, and Naomi Hino-Fukuyo. "Glabellar ecchymosis and headache: Variations of pain-associated ecchymosis." Psychiatry and Clinical Neurosciences 69, no. 6 (January 19, 2015): 385. http://dx.doi.org/10.1111/pcn.12266.

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5

Vijayan, Srimathy, Carolyn Orr, and Catherine Franconi. "063 Headache with periorbital ecchymosis; a rare clinical entity." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A20.3—A21. http://dx.doi.org/10.1136/jnnp-2019-anzan.55.

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ObjectivesPrimary headache disorders are common with migraine and tension headache accounting for the vast majority of cases. A smaller proportion suffer from trigeminal autonomic cephalgia (TAC). We present a 23-year-old Caucasian female who described characteristic, episodic headaches starting with a dull retro-orbital/bi-frontal pressure evolving, over the course of 1 minute, to experience florid periorbital ecchymosis. While this phenomenon has been described in the literature, the characteristics of our case are unique and noteworthy of reporting.MethodsWe reviewed the literature surrounding this rare entity by using PubMed/OVID databases and the search terms ‘Headache AND ecchymosis’.ResultsCase reports exist in older patients1–3, where the headache is side locked and associated with other autonomic characteristics such as periorbital oedema, conjunctival injection and tearing. Our case is a young female with only ecchymosis in a unilateral and/or bilateral manner and no other autonomic or indeed migraine features. The patient underwent vascular/cranial imaging and blood tests to exclude haematological, autoimmune, vasculitic causes for this presentation which were unrewarding.ConclusionVariations on this clinical entity are described;1–4 we hope this report may bring attention to this fascinating phenomenon. The pathophysiological process is likely to be similar to those implicated in TACs, namely activation of the trigemino-neurovascular system and facial autonomic pathways. The release of neuromediators such as CGRP, VIP and Substance P cause blood vessel fragility resulting in diapedesis. Optimal treatment regimens are unknown but various agents have been trialled. Our patient declined treatment and continues to be followed.ReferencesDeBroff B, et al. Migraine Associated with Periorbital Ecchymosis. Headache 1990;30:260–263.Dafer R, et al. Atypical Chronic Headache and Recurrent Facial Ecchymosis: A Case Report. Neuro-Ophthalmology 2011;35:76–77.Nozzolillo D, et al. Migraine associated with facial ecchymoses ipsilateral to the symptomatic side. J Headache Pain ( 2004) 5:256–259.Sethi PK, et al. Teaching neuroimages: Red forehead dot syndrome and migraine revisited. Neurology 2015;85;e28.
6

DUARTE, Sara, and Carlos ANDRADE. "Migrainous periorbital ecchymosis." Arquivos de Neuro-Psiquiatria 78, no. 9 (September 2020): 597. http://dx.doi.org/10.1590/0004-282x20200079.

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7

P., Joshisree K., Rajesh G., and Siddarama R. "CORTICOSTERIODS INDUCED ECCHYMOSIS." International Journal of Pharmacy and Pharmaceutical Sciences 10, no. 1 (January 1, 2018): 211. http://dx.doi.org/10.22159/ijpps.2018v10i1.22212.

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Corticosteroids are the steroid hormones which are mainly used in the treatment of various diseases like rheumatoid arthritis, osteoarthritis, rheumatic fever, gout, allergic reactions, renal diseases and haematological diseases. Prolonged use of corticosteroids causes a number of undesirable effects. Major adverse drug reaction (ADR’s) includes ulcers/gastrointestinal bleeding, osteoporosis, increased risk of heart diseases and decreased in bone density. Here we report a case of male patient of 72years old who was confirmed with cervical osteoarthritis and using oral corticosteroid (OCS) (methylprednisolone) since 6 y. While the patient was on therapy ecchymosis was noticed. The relation between suspected drug and ADR was established by performing ADR assessment scale, whereas both de-challenge and re-challenge was done, and ADR assessment scales like Naranjo’s scale, WHO UMC scales showed probable ADR, it can be managed by stopping the drug or using alternative days. Close monitoring of blood cortisol levels in a patient using oral corticosteroids (OCS) should be done.
8

Kohn, Sarah, and Lawrence A. Labbate. "Venlafaxine and Ecchymosis." Canadian Journal of Psychiatry 42, no. 1 (February 1997): 91. http://dx.doi.org/10.1177/070674379704200126.

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9

Sherman, Scott C., and Jennifer Lee. "Plantar Ecchymosis Sign." Journal of Emergency Medicine 57, no. 2 (August 2019): e57-e58. http://dx.doi.org/10.1016/j.jemermed.2019.04.033.

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10

Banerjee, A. K., and M. Burke. "Body wall ecchymosis." British Journal of Surgery 76, no. 1 (January 1989): 104. http://dx.doi.org/10.1002/bjs.1800760143.

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11

BEŞİR, Ahmet, Ersagun TUĞCUGİL, Ali AKDOĞAN, and Murat LİVAOĞLU. "Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery." Cukurova Medical Journal 47, no. 4 (December 28, 2022): 1568–77. http://dx.doi.org/10.17826/cumj.1134070.

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Purpose: This study investigated the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and severe postoperative edema and ecchymosis after open rhinoplasty. Materials and Methods: The study was carried out retrospectively in 165 ASA I-II patients aged 18-45 years who underwent open rhinoplasty in the Department of Plastic and Reconstructive Surgery. The patients were grouped based on their scores on the edema and ecchymosis scales. The degree of edema and ecchymosis was considered “minimal” (Group M) in those scoring 0-2 points and “severe” (Group S) in those scoring 3-4 points. Periorbital edema and ecchymosis of the patients in both groups were scored based on the digital photographs taken on the 1st postoperative day. Results: There was no significant difference in the demographic and clinical characteristics of the patients grouped according to the degree of edema and ecchymosis. The optimal cut-off value of NLR was 2.1 (AUC = 0.747, Sensitivity = 0.666, Specificity = 0.707) for edema and 1.5 (AUC = 0.747, Sensitivity = 0.869, Specificity = 0.470) for ecchymosis. Multivariable analyzes for the development of edema and ecchymosis identified NLR (4.67 [2.38-9.40] and 6.54 [3.02-15.08, respectively) as a statistically significant independent prognostic factor. Conclusion: This study identified preoperative NLR as a predictor value of severe postoperative edema and ecchymosis after open rhinoplasty.
12

Cotter, C., E. Howard, E. Williamson, and A. Tewari. "Relapsing–remitting linear ecchymosis." Clinical and Experimental Dermatology 46, no. 5 (March 15, 2021): 931–32. http://dx.doi.org/10.1111/ced.14582.

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13

Hayashi, Anna, Toshinori Nishizawa, Tatsuya Fujii, and Haruhiro Uematsu. "Popeye sign with ecchymosis." BMJ Case Reports 14, no. 4 (April 2021): e242908. http://dx.doi.org/10.1136/bcr-2021-242908.

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14

Deeren, Dries. "Neck Ecchymosis in Amyloidosis." Journal of Clinical Oncology 30, no. 5 (February 10, 2012): e54-e54. http://dx.doi.org/10.1200/jco.2011.39.1151.

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15

Díaz Mejía, Nely Mercy, Eduardo Josué Flores Umanzor, and Gala Caixal. "Macroglossia and periorbital ecchymosis." European Journal of Internal Medicine 33 (September 2016): e3-e4. http://dx.doi.org/10.1016/j.ejim.2016.02.010.

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16

Hardy, M., R. A. Eiferman, and J. Johnston. "Enucleation and Orbital Ecchymosis." Archives of Ophthalmology 105, no. 5 (May 1, 1987): 618. http://dx.doi.org/10.1001/archopht.1987.01060050036024.

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17

Ozturk, Selcuk, Kagan Turker Akbaba, Suleyman Kilic, Tufan Cicek, Levent Peskircioglu, Izzet Tandogan, Ahmet Gurlek, Ozbay Aydemir, Mehmet Ileri, and Ertan Yetkin. "Ecchymosis and Coldness in Peripheral Varicose Vein Patients: Observations From VEIN-TURKEY Study." International Journal of Lower Extremity Wounds 19, no. 3 (May 1, 2020): 262–68. http://dx.doi.org/10.1177/1534734620917911.

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The purpose of this subgroup analysis is to investigate and analyze the venous leg symptoms including sense of coldness and sign of ecchymosis in patients with or without peripheral varicose veins (PVVs) from VEIN-TURKEY study population. A total of 600 patients, who were enrolled to VEIN-TURKEY study recently, were included in this subgroup analysis. Patients were examined clinically for the presence and severity of PVV and varicocele. Patients were asked to answer the VEINES-Sym questionnaire consisting of 10 parts and questions about ecchymosis and coldness in their legs. Frequency of symptoms present in the VEINES-Sym instrument, coldness (16.6%, 6.5%, P = .002, respectively), and ecchymosis (16.6%, 2.7%, P < .001, respectively) were significantly higher in patients with PVV compared to patients without PVV. Mean score of each symptom was significantly lower in PVV (+) patients including scores of ecchymosis and coldness. Total VEINES-Sym score was also correlated with the scores of ecchymosis ( r = 0.18, P < .001) and coldness ( r = 0.35, P < .001). Logistic regression analysis revealed that heavy legs, aching legs, night cramps, and ecchymosis are significantly and independently associated with PVV. In conclusion, sign of ecchymosis and coldness are significantly higher in patients with PVV compared to patients without PVV in a population recruited from the urology clinics. In clinical evaluation, presence or sign of ecchymosis and coldness in legs should be considered to be compatible with PVV in the absence of trauma, hematologic pathologies including antiplatelet treatment, and arterial stenosis or obstruction.
18

Kemaloğlu, Cemal. "Saphenous vein diameter is a single risk factor for early recanalization after endothermal ablation of incompetent great saphenous vein." Vascular 27, no. 5 (March 16, 2019): 537–41. http://dx.doi.org/10.1177/1708538119837110.

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Background and aim The aim of this study was to compare endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) techniques for efficacy and side effects for great saphenous vein (GSV) ablation. Materials and methods Two hundred twenty-one patients and 287 extremities that underwent GSV ablation with EVLA and RFA methods were analysed retrospectively; 135 GSVs were treated with EVLA, 152 GSVs were treated with RFA. Physical examination and Ultrasound (US) records at the first week, first month and third month were evaluated. Recanalization, endothermal heat-induced thrombosis formation, presence of ecchymosis greater than 10 cm and GSV diameter parameters were statistically analyzed. Results In the RFA group, 96.7% of the GSVs that were ablated were occluded at the end of the third month. In the EVLA group, this rate was 92.6%. There was no statistically significant difference between success of ablation ( P = 0.118). In the RFA group, ecchymotic areas, that is larger than 10 cm diameter were observed in 16 extremities, whereas in the EVLA group, 66 of 135 (48.9%) limbs were found to have ecchymotic area larger than 10 cm ( P < 0.001). More recanalizations were observed in GSVs larger than 10 mm in diameter which was statistically significant ( P < 0.001). Conclusion Both EVLA and RFA methods are effective in treating GSV reflux. Compared to the EVLA, less ecchymosis occurs after RFA procedures. Regardless of the type of method used, the GSV diameter is a single predictor of recanalization.
19

Jafari, Mahboubeh, Mojtaba Maleki Delarestaghi, Hesam Jahandideh, Shahin Rajaeih, Sara Ghashghaei, and David A. Wood. "The Effect of Subcutaneous Dexamethasone to Reduce Edema and Ecchymosis in Rhinoplasty Patients." International Journal of Otolaryngology 2022 (February 14, 2022): 1–7. http://dx.doi.org/10.1155/2022/3054767.

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Background. Rhinoplasty is one of the most common types of cosmetic surgery undertaken. In most rhinoplasty patients, an osteotomy is used to reshape the nasal pyramid. The most common complications following osteotomy are edema and ecchymosis. Edema and ecchymosis have a significant effect on a patients’ satisfaction with surgery and their return to social activities. For this purpose, various methods have been used to reduce edema and ecchymosis, including intravenous injection of corticosteroids, cold compresses, and tranexamic acid. Objective. To reduce edema and ecchymosis in rhinoplasty patients by administering a subcutaneous injection of dexamethasone and thereby prevent unwanted systemic side effects of corticosteroid treatments. Method. We conduct a hospital-based nonrandomised study of rhinoplasty patients, with their informed consent treated over the course of one year. Dexamethasone was injected on one side of consenting patient’s face immediately before surgery and the results were compared with the opposite side that was not injected. The face images of patients were taken on the front view on the first, third, seventh, and fourteenth days following the treatment. The grade of edema and ecchymosis encountered in each patient was determined by three ENT specialists. The degree of edema and ecchymosis was compared on the injected and noninjected sides and the findings were statistically analysed. The nonrandomised study considered 42 rhinoplasty patients. The mean age of patients was 27.9 years and their age ranged between 17 and 52 years. For 20 patients (47.6%), injection was performed on the right side, and for 22 patients (52.3%), injection was performed on the left side. Findings. The statistical analysis of patient outcomes reveals that a supraperiosteal injection of dexamethasone was not effective in reducing edema and ecchymosis after rhinoplasty.
20

Namazi, Mohammad R. "Ecchymosis-like hyperpigmented mycosis fungoides." Annals of Saudi Medicine 28, no. 3 (May 2008): 228–29. http://dx.doi.org/10.5144/0256-4947.2008.228.

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21

Muthu, Kavitha, Sathya Kannan, Senthilkumar Muthusamy, and Preena Sidhu. "Palatal ecchymosis associated with irrumation." Indian Journal of Dermatology, Venereology, and Leprology 81, no. 5 (2015): 505. http://dx.doi.org/10.4103/0378-6323.162343.

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22

Singh, Sweta, Jaidrath Kumar, and Ankit Abhishek. "Child presenting with ocular ecchymosis." Oman Journal of Ophthalmology 11, no. 3 (2018): 303. http://dx.doi.org/10.4103/ojo.ojo_181_2018.

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23

Selman, Selman M. "Amlodipine Causes Ecchymosis and Hematuria." Research Journal of Pharmacy and Technology 11, no. 9 (2018): 3799. http://dx.doi.org/10.5958/0974-360x.2018.00696.0.

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24

Michelerio, Andrea, Stefania Barruscotti, Nathalie Rizzo, and Carlo Tomasini. "An Ecchymosis with Fulminant Evolution." Dermatopathology 8, no. 4 (December 11, 2021): 535–38. http://dx.doi.org/10.3390/dermatopathology8040057.

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We present the case of an 83-year-old woman who presented with an advanced cutaneous angiosarcoma of the head. The tumor had first appeared as a small ecchymosis on her forehead 3 months before admission. There was an extremely rapid and dramatic evolution, as evidenced by photographic documentation by her relatives. Unfortunately, the delay in access to the healthcare system due to the COVID-19 pandemic lockdown and the fulminant growth were the main determinants for our patient outcome.
25

Dodderer, Joshua K., Rahela Aziz-Bose, and Joshua Nagler. "Infant With Unilateral Periorbital Ecchymosis." Annals of Emergency Medicine 79, no. 2 (February 2022): 116–47. http://dx.doi.org/10.1016/j.annemergmed.2021.07.131.

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26

Mulleman, Denis, and Philippe Goupille. "A Medical Mystery — Extensive Ecchymosis." New England Journal of Medicine 353, no. 22 (December 2005): 2384. http://dx.doi.org/10.1056/nejmicm040655.

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27

DeBroff, Brian M., and Egilius L. H. Spierings. "Migraine Associated with Periorbital Ecchymosis." Headache: The Journal of Head and Face Pain 30, no. 5 (April 1990): 260–63. http://dx.doi.org/10.1111/j.1526-4610.1990.hed3005260.x.

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28

Abouda, Maher, and Sonia Baccari Ezzine. "Facial ecchymosis and periorbital oedema." Emergency Medicine Journal 33, no. 8 (July 20, 2016): 556. http://dx.doi.org/10.1136/emermed-2015-205439.

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29

Wang, Han, Jiacheng Liu, Xiaofei Lai, Xinyu Li, and Wei Huang. "The Role of Anti-Factor Xa Activity in the Management of Ecchymosis in Patients Receiving Rivaroxaban after Total Knee Arthroplasty." Journal of Clinical Medicine 12, no. 3 (February 1, 2023): 1161. http://dx.doi.org/10.3390/jcm12031161.

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This study aims to evaluate the efficacy of anti-factor Xa activity (aFXa) in predicting ecchymosis after total knee arthroplasty (TKA). One hundred and two unilateral primary TKA patients were recruited consecutively in this prospective observational study. Participants received rivaroxaban (10 mg p.o. qd) from postoperative day 1 (POD1) to POD35 and were divided into a non-ecchymosis group (group A) and an ecchymosis group (group B). AFXa was assessed as the primary outcome on POD1 and POD3. Prothrombin time (PT), activated partial thromboplastin time (APTT) and thromboelastography (TEG) were recorded both preoperatively and postoperatively (on POD1 and POD3). Other outcomes, including venous thromboembolism (VTE), blood loss and wound complications were also collected and compared. As a result, 27.5% of the participants (n = 28) were allocated into group B. Demographic data were comparable between the two groups. The aFXa levels in group B were significantly higher than those in group A on POD1 and POD3, and the aFXa level was assessed as an independent risk factor for ecchymosis. The cut-off value of aFXa was determined to be 121.38 ng/mL at maximal Youden index, associated with area under the receiver operating characteristics curve of 0.67. Group B experienced significantly more blood loss and wound complications than group A. No statistical difference was detected regarding PT, APTT and TEG parameters. AFXa is a promising parameter to predict ecchymosis after TKA. Patients with aFXa > 121.38 ng/mL should be considered as high-risk population for postoperative ecchymosis and may require intense monitoring or dosage modification of anticoagulants.
30

Alvarez, Erick F., Karen E. Olarte, and Mayur S. Ramesh. "Purpura Fulminans Secondary toStreptococcus pneumoniaeMeningitis." Case Reports in Infectious Diseases 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/508503.

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Purpura fulminans (PF) is a rare skin disorder with extensive areas of blueblack hemorrhagic necrosis. Patients manifest typical laboratory signs of disseminated intravascular coagulation (DIC). Our case describes a 37-year-old previously healthy man who presented with 3 days of generalized malaise, headache, vomiting, photophobia, and an ecchymotic skin rash. Initial laboratory workup revealed DIC without obvious infectious trigger including unremarkable cerebrospinal fluid (CSF) biochemical analysis. There was further progression of the skin ecchymosis and multiorgan damage consistent with PF. Final CSF cultures revealedStreptococcus pneumoniae. Despite normal initial CSF biochemical analysis, bacterial meningitis should always be considered in patients with otherwise unexplained DIC as this may be an early manifestation of infection. PF is a clinical diagnosis that requires early recognition and prompt empirical treatment, especially, in patients with progressive altered mental status, ecchymotic skin rash, and DIC.
31

Tasman, Abel-Jan. "Reducing Periorbital Edema and Ecchymosis after Rhinoplasty: Literature Review and Personal Approach." Facial Plastic Surgery 34, no. 01 (February 2018): 014–21. http://dx.doi.org/10.1055/s-0037-1617444.

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Postoperative periorbital edema and ecchymosis are most bothersome to rhinoplasty patients. The degree of swelling and bruising is influenced by several factors, and numerous prophylactic and therapeutic measures have been described in the literature. This article reviews the current literature and concludes with the author's suggestions on how to best minimize postoperative periorbital edema and ecchymosis.
32

Weissler, Jason M., Joseph Banuelos, Vanessa E. Molinar, and Nho V. Tran. "Local Infiltration of Tranexamic Acid (TXA) in Liposuction: A Single-Surgeon Outcomes Analysis and Considerations for Minimizing Postoperative Donor Site Ecchymosis." Aesthetic Surgery Journal 41, no. 7 (January 5, 2021): NP820—NP828. http://dx.doi.org/10.1093/asj/sjaa437.

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Abstract Background Tranexamic acid (TXA) has gained increasing recognition in plastic surgery as a dependable adjunct capable of minimizing blood loss, ecchymosis, and edema. To date, there have been limited data on the utilization of TXA to mitigate liposuction donor site ecchymosis. Objectives The authors sought to investigate whether infiltration of TXA into liposuction donor sites safely reduces postoperative ecchymosis. Methods A single-surgeon retrospective cohort study was performed to analyze patients undergoing autologous fat transfer for breast reconstruction between 2016 and 2019. Following lipoaspiration, patients in the intervention group received 75 mL of TXA (3 g in NaCl 0.9%) infiltrated into the liposuction donor sites, whereas the historical controls did not. Patient demographics, degree of ecchymosis, surgical complications, and thromboembolic events were examined. A blinded assessment of postoperative photographs of the donor sites was performed. Results Overall, 120 autologous fat grafting procedures were reviewed. Sixty patients received TXA, whereas 60 patients did not. Patient demographics and comorbidities were similar among the groups. No difference existed between groups regarding donor site locations, tumescent volume, lipoaspirate volume, or time to postoperative photograph. Ten blinded evaluators completed the assessment. The median bruising score of patients who received TXA was significantly lower than that of patients who did not (1.6/10 vs 2.3/10, P = 0.01). Postoperative complications were similar among the groups. Adverse effects of TXA were not observed. Conclusions Patients who received local infiltration of TXA into the liposuction donor sites were found to have less donor site ecchymosis than patients who did not. Further prospective randomized studies are warranted. Level of Evidence: 4
33

Oliver, Jeremie, Deanna Menapace, Ahmed Younes, Chelsey Recker, Grant Hamilton, and Oren Friedman. "Validation of the Modified Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE) Questionnaire: A Prospective Analysis of Facial Plastic and Reconstructive Surgery Procedures." Facial Plastic Surgery 34, no. 01 (January 11, 2018): 095–101. http://dx.doi.org/10.1055/s-0037-1615282.

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AbstractAlthough periorbital edema and ecchymosis are commonly encountered after facial plastic and reconstructive surgery procedures, there is currently no validated grading scale to qualify these findings. In this study, the modified “Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE)” questionnaire is used as a grading scale for patients undergoing facial plastic surgery procedures. This article aims to validate a uniform grading scale for periorbital edema and ecchymosis using the modified SPREE questionnaire in the postoperative period. This is a prospective study including 82 patients at two different routine postoperative visits (second and seventh postoperative days), wherein the staff and resident physicians, physician assistants (PAs), patients, and any accompanying adults were asked to use the modified SPREE questionnaire to score edema and ecchymosis of each eye of the patient who had undergone a plastic surgery procedure. Interrater and intrarater agreements were then examined. Cohen's kappa coefficient was calculated to measure intrarater and interrater agreement between health care professionals (staff physicians and resident physicians); staff physicians and PAs; and staff physicians, patients, and accompanying adults. Good to excellent agreement was identified between staff physicians and resident physicians as well as between staff physicians and PAs. There was, however, poor agreement between staff physicians, patients, and accompanying adults. In addition, excellent agreement was found for intraobserver reliability during same-day visits. The modified SPREE questionnaire is a validated grading system for use by health care professionals to reliably rate periorbital edema and ecchymosis in the postoperative period. Validation of the modified SPREE questionnaire may improve ubiquity in medical literature reporting and related outcomes reporting in future.
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Taş, Süleyman. "The Effects of Vibration and Pressure Treatments in the Early Postoperative Period of Rhinoplasty." Aesthetic Surgery Journal 40, no. 6 (August 13, 2019): 605–16. http://dx.doi.org/10.1093/asj/sjz226.

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Abstract Background The early postoperative period can be distressing for the patients undergoing rhinoplasty since edema and ecchymosis are common complications. Objectives To analyze the effects of the vibration and pressure treatments in the early postoperative period of rhinoplasty. Methods Sixty patients, who had undergone rhinoplasty, were randomized into 3 groups: group 1 (control group, n = 20) received classic nasal casting, group 2 (n = 20) received nasal cast with an elastic bandage to hold it on the face, and group 3 (n = 20) received vibration treatment in addition to that in group 2 following the rhinoplasty. They were evaluated preoperatively and postoperatively at 3 and 7 days in a prospective study. The postoperative edema and ecchymosis were scored by 2 independent surgeons. The postoperative pain was measured using the visual analog scale, and the necessity of anti-inflammatory medication (and the dose needed) and the cast comfort was questioned. The sebaceous activity of the nose skin was examined. A preoperative and postoperative seventh day sonographic study was performed to evaluate the tissue edema objectively. Results The pressure treatment decreased the edema and ecchymosis significantly compared with the control group. The vibration treatment minimized edema, ecchymosis, sebaceous activity of the nose skin, pain score, and the need for anti-inflammatory medication, and increased the cast comfort significantly compared with the other groups (P &lt; 0.0001). Conclusions Rapid regression of edema and ecchymosis may be achieved using the vibrating nasal cast technique that may minimize patient discomfort, pain, and sebaceous activity following rhinoplasty. Level of Evidence: 1
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Seamont, David, Ivan Vrcek, Tanuj Nakra, and Ronald Mancini. "Arnica and Bromelain for Blepharoplasty-Associated Ecchymosis." American Journal of Cosmetic Surgery 35, no. 3 (December 18, 2017): 130–34. http://dx.doi.org/10.1177/0748806817743904.

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Homeopathic and naturopathic supplementation has gained increasing popularity as complementary and alternative medicine (CAM) modalities. Arnica and Bromelain are 2 commonly used supplements thought to be effective in reducing ecchymosis. This study was designed to explore the impact of combination therapy with Arnica and Bromelain on postoperative ecchymosis in patients undergoing blepharoplasty. In total, 130 patients undergoing upper eyelid blepharoplasty were enrolled. Patients with bleeding diatheses or inability to comply with cessation of anticoagulants were excluded. Aspirin and all naturopathic and homeopathic treatments were discontinued 2 weeks prior to surgery. In all, 64 patients received oral Arnica and Bromelain treatment starting 7 days prior to surgery and extending 7 days postoperatively. Sixty-six patients received no supplementation. Upper eyelid blepharoplasty was performed with skin flap excision, hemostasis with electrocautery, and closure with running 6-0 fast absorbing plain gut. Postoperative photos were taken 7 days following surgery. Photos were analyzed by 2 blinded reviewers, who graded the severity of ecchymosis using a visual analog scale. All 130 patients were seen during the postoperative course. There were no patients lost to follow-up, and there were no adverse reactions to the treatment protocol that necessitated discontinuation of Arnica and Bromelain. Average ecchymosis in the treatment arm was 5.00 compared with 4.43 in the control arm ( P = .67). At the conclusion of this study, the investigators find insufficient evidence that the combination of Arnica and Bromelain is effective at producing a statistically significant difference in ecchymosis following upper eyelid blepharoplasty.
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Srivathsa, SrikanthH. "Oral Ecchymosis in elderly: Senile purpura." Journal of Indian Academy of Oral Medicine and Radiology 27, no. 2 (2015): 331. http://dx.doi.org/10.4103/0972-1363.170182.

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Pandhi, Deepika, Vishal Gaurav, and Mrinalini Kotru. "Ecchymosis: A subtle sign unmasking malignancy." Indian Dermatology Online Journal 13, no. 2 (2022): 262. http://dx.doi.org/10.4103/idoj.idoj_388_21.

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TUCKER, MIRIAM E. "Long-Pulsed Laser Speeds Ecchymosis Healing." Skin & Allergy News 40, no. 6 (June 2009): 32. http://dx.doi.org/10.1016/s0037-6337(09)70276-1.

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39

Dryden, Robert M., Allan E. Wulc, and Douglas Day. "Eyelid Ecchymosis and Proptosis in Lymphangioma." American Journal of Ophthalmology 100, no. 3 (September 1985): 486–87. http://dx.doi.org/10.1016/0002-9394(85)90526-4.

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Yang, Ting-Hua, Wei-Yu Chen, and Hsiou-Hsin Tsai. "Periarticular ecchymosis-like plaques and nodules." Journal of the American Academy of Dermatology 75, no. 1 (July 2016): e1-e2. http://dx.doi.org/10.1016/j.jaad.2015.11.015.

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41

Mulleman, Denis, and Philippe Goupille. "Medical Mystery: Extensive Ecchymosis — The Answer." New England Journal of Medicine 354, no. 4 (January 26, 2006): 419–20. http://dx.doi.org/10.1056/nejmc055547.

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42

Thawabi, Mohammad, Ashraf Jmeian, and Fayez Shamoon. "Extensive Ecchymosis Associated with Infective Endocarditis." Heart, Lung and Circulation 23, no. 9 (September 2014): e188-e189. http://dx.doi.org/10.1016/j.hlc.2014.04.253.

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43

Batra, Gaytri. "Application of Ice Cube prior to Subcutaneous Injection of Heparin in Pain Perception and Ecchymosis of Patients with Cardiovascular Problems." Nursing Journal of India CV, no. 04 (2014): 155–59. http://dx.doi.org/10.48029/nji.2014.cv403.

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In this experimental study of patients with cardiovascular problems, conducted at Safdarjung Hospital, New Delhi, purposive sampling technique was done from cardiology ward and CCU to obtain adequate samples. The sample comprised of 30 experimental group patients and 30 control group patients. The conceptual framework was based on the system model proposed by Ludwig Van Bertalanffy in 1957. Quasi experimental research approach was adopted for the study with post-test only control group design. The independent variable for the study was the ice cube application for 3 min and the dependent variables were pain perception and ecchymosis. The tools used for data collection were, structured interview schedule for sample characteristics, numerical rating scale for pain for subjective assessment, transparent ruler scale to measure the total surface area of ecchymosis, and for treatment ice-cubes in latex glove for giving cold compress. Subjects were asked to rate pain by showing the flash chart of standard pain rating scale immediately after the needle was withdrawn and ecchymosis was observed 48 hrs after the day of injection. The obtained difference between experimental and control group ecchymosis score and pain perception score was statistically significant as evident from t-value at 0.05 level of significance.
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Rajati, Mohsen, Mehdi Bakhshaee, and Kamran Khazaeni. "Periorbital Ecchymosis and Subconjunctival Hemorrhage following Ear Surgery." ISRN Otolaryngology 2013 (September 30, 2013): 1–4. http://dx.doi.org/10.1155/2013/791068.

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Objective. To evaluate the occurrence of two periorbital complications of surgery for Chronic Suppurative Otitis Media (CSOM) and discuss the potential pathophysiologic mechanisms. Materials and Methods. This is a retrospective review of the CSOM surgeries performed between Oct, 2005, and Jan, 2011, in our hospital. The early postoperative conditions of the patients were scrutinized to identify periorbital ecchymosis and subconjunctival hemorrhage. Results. Eight cases out of 756 patients were noted to have periorbital ecchymosis, and two of the patients also had simultaneous subconjunctival hemorrhage. All cases in which the complications occurred had undergone tympanoplasty, and in three patients mastoidectomy had also been performed. The age of the affected patients ranged from 24 to 70 years old. In all of them the condition ensued the day after the surgery and became better within 5 to 10 days. Complete recovery took approximately 1 month. Conclusion. Periorbital ecchymosis and subconjunctival hemorrhage are rare but safe complications of ear surgeries. The conditions are self-limiting and no management is necessary.
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Kim, Ji-Sun, Sun Hong Kim, Hyesook Lee, Byung Guk Kim, and Se Hwan Hwang. "Effects of Periosteal Elevation Before Lateral Osteotomy in Rhinoplasty: A Meta-Analysis of Randomized Controlled Trials." Clinical and Experimental Otorhinolaryngology 13, no. 3 (August 1, 2020): 268–73. http://dx.doi.org/10.21053/ceo.2019.01599.

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Objectives. Although osteotomy is an important part of rhinoplasty, it is known to be closely related to postoperative eyelid edema and ecchymosis. We aimed to evaluate the effects of periosteal elevation prior to osteotomy on eyelid edema and ecchymosis.Methods. Two authors reviewed studies in the Medline, Scopus, and Cochrane databases published through May 2019. Randomized controlled trials comparing periosteal elevation (subperiosteal tunneling) with periosteal preservation that reported eyelid edema or ecchymosis or subconjunctival hemorrhage as outcomes of interest were included. From each study, the baseline characteristics of the study subjects, the quality of the study, the number of patients in the treatment and control groups, and outcomes were extracted.Results. Data for meta-analysis were identified in six studies with a total of 208 patients. Eyelid ecchymosis and edema within 3 days postoperatively were significantly more common in the periosteal elevation group than in the preservation group, although such an association was not found for edema on postoperative day 7 (standardized mean difference [SMD], 0.21; 95% confidence interval [CI], –0.09 to 0.50; I<sup>2</sup> =0%). There was no significant difference in subconjunctival hemorrhage on day 1 (SMD, 0.31; 95% CI, –0.09 to 0.72; I<sup>2</sup> =0%).Conclusion. Periosteal preservation during lateral osteotomy may reduce eyelid edema and ecchymosis compared to periosteal elevation. Further studies with rigorous research methods should be carried out to determine the effectiveness of different techniques in lateral osteotomy.
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Kayiran, Oguz, and Caglar Calli. "The effect of periorbital cooling on pain, edema and ecchymosis after rhinoplasty: a randomized, controlled, observer-blinded study." Rhinology journal 54, no. 1 (March 1, 2016): 32–37. http://dx.doi.org/10.4193/rhino15.177.

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Introduction: Success and satisfactory results in rhinoplasty are established not only with flawless surgery but also with meticulous perioperative care. Pain stays at the centre of these circumstances. Besides, several contributing perioperative factors such as periorbital edema and ecchymosis play key role on the patients' comfort. Methods: Septorhinoplasty was carried out in 50 patients between February and May 2014 under general anesthesia. Local anesthesia with lidocaine and adrenaline combination was done prior to incision. Following the procedure, silicone gel packs were applied. One periorbital region was cooled after surgery whereas the opposite site was left uncooled. Periorbital edema-ecchmosis and pain intensity were graded and noted 1 hour, 1 day, 3 days, 1 week and 1 month after surgery. Results: Cold application seriously reduced postoperative edema and ecchymosis at the first week (p=0.001 for the first 3 days and p=0.006 at first week). Pain was reduced with cooling not on the first hour (p>0.05), but on the forthcoming days throughout the first week (p<0.005). Operation time revealed that primary cases were carried out quicker than revisional surgery. Moreover, pain scores were found lower in primary cases than revisions, especially in the first 3 days. These finding were approved statistically. Conclusion: Cooling of the periorbital region reduces edema and ecchymosis as well as pain; however 3 days of use is enough after rhinoplasty. One hour after surgery, cooling does not affect the pain but reduce edema and ecchymosis.
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NAGASHIMA, TAKAO, and SEIJI MINOTA. "Extensive Ecchymosis due to Rotator Cuff Tear." Journal of Rheumatology 44, no. 12 (December 2017): 1875. http://dx.doi.org/10.3899/jrheum.170545.

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48

Eser, Gokce, Mustafa Berber, and Hulya Ercan Sarıcoban. "Ecchymosis: An Unexpected Side Effect of Montelukast." Asthma Allergy Immunology 18, no. 3 (September 22, 2020): 156–58. http://dx.doi.org/10.21911/aai.570.

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Montelukast is a leukotriene receptor antagonist that is used to treat allergy and asthma. It acts as a cysteinyl leukotriene receptor antagonist that blocks the action of leukotrienes and decreases inflammation. This agent is generally well tolerated in clinical practice. Although montelukast is generally considered as a safe drug, it can cause a few adverse drug reactions. In this case study, a rare side effect of montelukast that has been reported only twice before is presented. The importance of this case report is that the youngest patient who had ecchymosis due to the use of montelukast treatment is reported
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Aydur, Emin, Serdar Göktas, Yusuf Kibar, Hasan Cem Irkilata, Fatih Örs, and A. Fuat Peker. "Case Report: Scrotal Ecchymosis after Shockwave Lithotripsy." Journal of Endourology 20, no. 12 (December 2006): 1002–4. http://dx.doi.org/10.1089/end.2006.20.1002.

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50

Tas, Adnan. "PERIORBITAL ECCHYMOSIS FOLLOWING AN UPPER GASTROINTESTINAL ENDOSCOPY." Gastroenterology Nursing 36, no. 1 (2013): 72. http://dx.doi.org/10.1097/sga.0b013e318282a891.

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