Differential Diagnosis for a Bruise on the Face
- Single Most Likely Diagnosis + Trauma (e.g., accidental injury, fall, or assault): This is the most common cause of a bruise on the face, given the exposed nature of the area and the frequency of minor accidents or altercations.
- Other Likely Diagnoses + Contact sports injury: Participation in contact sports increases the risk of facial bruising due to collisions or falls. + Surgical or procedural complication: Recent facial surgery or procedures (e.g., cosmetic surgery, dental procedures) can lead to bruising. + Allergic reaction or angioedema: Though less common, severe allergic reactions can cause facial swelling and bruising.
- Do Not Miss Diagnoses + Basilar skull fracture: A bruise around the eyes or behind the ears (raccoon eyes or Battle's sign) can indicate a basilar skull fracture, which is a medical emergency. + Orbital fracture: Significant trauma to the face can result in an orbital fracture, which may present with bruising around the eye, among other symptoms. + Abusive injury (in children or vulnerable adults): It's crucial to consider the possibility of abuse, especially if the bruise's explanation doesn't match the injury or if there are repeated instances.
- Rare Diagnoses + Hematologic disorders (e.g., leukemia, bleeding disorders): Certain blood disorders can increase the propensity for bruising due to abnormalities in blood cells or clotting factors. + Vitamin deficiencies (e.g., vitamin C deficiency): Deficiencies in certain vitamins can affect collagen synthesis and blood vessel integrity, leading to easy bruising. + Vascular malformations or tumors: Though rare, vascular anomalies or tumors in the face can cause bruising, especially if they are subjected to trauma or rupture.