Organ system | Finding | Implications |
Skin and hair | Petechiae, especially in dependent areas | Suggestive of thrombocytopenia or platelet dysfunction |
Petechiae, purpura, and/or ecchymosis | Common with solar purpura, related to aging Generally, in bleeding disorders, petechiae and ecchymoses are not raised; raised petechiae or ecchymoses suggest an underlying vasculitis | |
Telangiectasias, especially around the lips or fingertips | May indicate HHT | |
Hyperelasticity | Ehlers-Danlos syndrome | |
Bruises | Location may indicate whether deliberately self-inflicted, traumatic, or spontaneous; ages of bruises may suggest a single event versus chronic condition | |
Hair follicle changes (perifollicular hemorrhages; corkscrew hairs) | Scurvy (vitamin C deficiency) | |
Albinism | Oculocutaneous albinism is associated with certain platelet disorders (Hermansky-Pudlak and Chediak-Higashi syndromes) | |
Mouth and nose | Macroglossia | Amyloidosis, with acquired clotting factor deficiencies (factor X, V, VWF, alpha-2-antiplasmin, PAI-1) |
Telangiectasias | May indicate HHT | |
Epistaxis | Common with many bleeding disorders | |
Bones and joints | Hypermobility | Ehlers-Danlos syndrome, osteogenesis imperfecta |
Fractures | Osteogenesis imperfecta | |
Thumb abnormalities | Certain platelet function disorders such as TAR | |
Joint bleeding | Clotting factor deficiencies (especially hemophilia A or B) | |
Liver and spleen | Splenomegaly | Liver disease with portal hypertension, myeloproliferative neoplasms, lymphoma |
Sign of liver disease | Clotting factor deficiencies, thrombocytopenia | |
Heart and lungs | Murmur of aortic stenosis | Acquired von Willebrand syndrome |
Pulmonary AVMs | May indicate HHT | |
Endocrine | Findings of hypothyroidism | Acquired von Willebrand syndrome |
Brain | Focal neurologic findings | Can be seen with any disorder |