Ecchymoses are asymptomatic or tender nonpalpable hemorrhages, usually 1 cm or more in diameter. They usually follow trauma, even mild trauma. The lesions are often linear or angulated and tend to occur on the dorsal hands, extensor forearms, pretibial area, and anterolateral thighs. The most common form of ecchymotic hemorrhage, actinic purpura, occurs on the sun-damaged skin of the elderly (Fig. 61-1).