Unexplained Bruising and Petechiae in Young Adult Female

Case at a Glance

A 24-year-old female presents with concerns about unexplained bruising and petechial rash, accompanied by significant health anxiety. Patient reports easy bruising since childhood but has recently noticed increased frequency of unexplained bruises and development of petechiae.

Patient's Story

The patient reports a lifelong tendency to bruise easily but has become increasingly concerned about dime-sized bruises appearing on her legs and occasionally on her arms without recollection of trauma. She also developed a small patch of petechiae under her arm without any remembered scratching or trauma to the area. The patient has a history of health anxiety and admits to extensive internet research, which has heightened her concerns about serious underlying conditions such as leukemia.

Initial Assessment

Patient appears anxious but otherwise well. She provided photographic documentation of the petechial rash in question. Physical examination revealed minor skin changes consistent with normal variations rather than pathological petechiae. Patient's anxiety level appeared disproportionate to clinical findings.

The Diagnostic Journey

Initial clinical impression suggested benign skin findings rather than concerning hematological pathology. The patient's presentation was more consistent with normal skin variations, possible minor trauma-related changes, or benign vascular lesions. Her history of medical anxiety was noted as a significant contributing factor to her distress.

Final Diagnosis

Benign skin findings, likely angiomas or normal skin variations. No evidence of hematological disorder or concerning pathology. Concurrent health anxiety disorder contributing to symptom magnification.

Treatment Plan

Patient reassurance and education about normal skin variations. Recommendation for mental health support to address underlying health anxiety. Advised to limit internet research regarding medical symptoms and to establish regular follow-up care with primary care physician for ongoing health concerns.

Outcome and Follow-up

Patient reported some relief following clinical reassurance. Encouraged to continue with existing therapy for anxiety management. No immediate medical intervention required. Patient advised to return if new concerning symptoms develop, but current findings do not warrant urgent investigation.