Normal childhood bruises or leukemia bruising? How to spot the difference

Children and others with leukemia are susceptible to bruising because their bodies don’t produce enough platelets to effectively clot damaged blood vessels.

Leukemia bruising occurs more easily and frequently than typical bruising, may show up in odd places, tends to take longer to clear up and can be part of a number of symptoms seen on a child’s skin, according to a Louisville pediatric hematologist/oncologist.

“Bruising from leukemia may occur for unclear reasons, and the bruises could stick around for longer than usual,” said Mustafa Barbour, M.D., pediatric hematologist/oncologist at Norton Children’s Cancer Institute, affiliated with the UofL School of Medicine.

Some of the initial signs of childhood leukemia don’t appear to be serious, but there are several symptoms for which parents can be on the lookout. One of the telltale signs of leukemia can be bruising, which is caused by damaged blood vessels underneath the skin.

Leukemia affects a child’s blood counts and bone marrow. It is the most common type of cancer in children. The majority of pediatric leukemia cases involve acute lymphoblastic leukemia, also known as ALL.

Norton Children’s Cancer Institute

Survival rates for children with leukemia have improved dramatically over the past 50 years, helped in part by the kind of research conducted at Norton Children’s Cancer Institute.

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Leukemia causes the bone marrow to produce too many abnormal white blood cells, so that keeps the body from being able to form a sufficient level of other important blood cells. People who have leukemia tend to bruise more easily because their bodies don’t produce enough platelets to clot damaged blood vessels effectively. Decreased number of platelets causes bruises resulting from a lighter touch or an impact that does not make sense for the number or severity of the bruises.

Tiny red spots on the skin, called petechiae, are another type of leukemia bruising. Petechiae is actually a cluster of very small bruises that may resemble a rash. Other symptoms may include frequent/severe nosebleeds, bone pain, fever, fatigue and swollen lymph nodes.

“Some signs of acute lymphoblastic leukemia can be similar to flu-like symptoms, but flu symptoms eventually will subside,” Dr. Barbour said. “If you have any concerns or notice that your child’s symptoms don’t improve, you should make an appointment.”

If you suspect abuse

Some bruising can be a result of abuse. If you suspect child abuse or neglect, you are required by law to report it — even if you aren’t sure. If a child is in immediate danger, call 911. Otherwise call anonymously in Kentucky: (877) KYSAFE1 (597-2331) or Indiana: (800) 800-5556.