Differential Diagnosis for Recurrent Ecchymosis and Headache

• Single most likely diagnosis
  • Vitamin C deficiency (Scurvy): This condition can cause easy bruising (ecchymosis) due to blood vessel fragility and can also lead to headaches. The combination of these symptoms, especially in the context of a poor diet, makes it a plausible initial consideration.
• Other Likely diagnoses
  • Bleeding disorders (e.g., von Willebrand disease, platelet function disorders): These conditions can lead to easy bruising and, in some cases, headaches due to bleeding episodes. A family history or other signs of bleeding tendency would support this diagnosis.
  • Medication side effects (e.g., anticoagulants, antiplatelets): Certain medications can cause bruising and, less commonly, headaches as side effects. A history of recent medication changes or use of these types of drugs would be relevant.
  • Hypothyroidism: Although less common, hypothyroidism can cause easy bruising and headaches among its myriad symptoms. This diagnosis would be considered, especially if other signs of hypothyroidism are present.
• Do Not Miss diagnoses
  • Leukemia or lymphoma: These cancers can cause easy bruising due to bone marrow suppression affecting platelet production and can also lead to headaches. Although less likely, missing these diagnoses could be fatal, making them critical to rule out.
  • Intracranial hemorrhage or vascular malformations: Headaches accompanied by ecchymosis could, in rare cases, indicate a more serious condition like an intracranial hemorrhage or a vascular malformation. Immediate imaging would be necessary to diagnose these conditions.
  • Infectious diseases (e.g., meningitis, sepsis): Certain infections can cause both ecchymosis (through disseminated intravascular coagulation) and severe headaches. These conditions are medical emergencies.
• Rare diagnoses
  • Ehlers-Danlos syndrome: A genetic disorder that affects connective tissue, leading to easy bruising and potentially headaches due to joint hypermobility or other complications.
  • Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, which can lead to bleeding tendencies and headaches, among a wide range of other symptoms.
  • Henoch-Schönlein purpura (HSP): A form of vasculitis that affects blood vessels and can cause bruising, but it is more commonly associated with palpable purpura, abdominal pain, and arthritis. Headaches can occur but are less typical.