Bruising on skin without any obvious reason - NRAS


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Bruising on skin without any obvious reason

ma73jon profile image
24 Replies

Hello All,

I am 46 and I have had rheumatoid arthritis since I was 38. Although I take a lot of medication it is still active and not under control. I get a great deal of pain particularly in my hands and I also feel fatigued a lot.

I am getting bruises on my arms and legs. There is no obvious reason for these bruises as I have had no impacts or blows. They are purple bruises and I currently have about 7 of them. I have been getting these bruises in different areas of my arms and legs for several years but have not thought to mention them to the Doctor. They come and go.

I am on the following medication:

Folic Acid, Hydroxychloroquine, Leflunomide, Prednisolone, Sulfasalazine.

Does anyone know if this is either a recognised side effect of rheumatoid arthritis or a side effect of any of my medication.

Thanks for your help.

24 Replies
Lolabridge profile image

I get these too and have always blamed them on the Prednisolone. I’m sorry to hear your RA is still not under control after 8 years. I think I would be asking the consultant to change my medication.

Deniseelk profile image

I have this too! It started the day I was given a depo-medrone shot! Not sure if it’s the steroids or just a side effect of RA ( I suspect the latter)! I have noticed now my disease is much better controlled the bruising is a lot less.

helixhelix profile image

If your blood tests are normal for blood counts etc then most likely culprit is the prednisone. I’d mention it. to your doctor, and also push to have your drugs reviewed. Do you know what your DAS score is and so whether you would qualify for biologics? You need to be above 5.3.

ma73jon profile image

Hi everyone, and thanks for all your replies. I have steroid injection from time to time too so possibly this is something to do with it. I will mention it to the specialist nurse next time I see them. I do have blood tests regularly. My nurses and doctors are trying different drugs but so far nothing is working (I switched to Leflunomide about five or 6 months ago but it is ineffective.) I have a DAS score below 5.3. I think that's probably because I am on prednisolone tablets.

Thanks once again to all of you

nomoreheels profile image

I've always bruised very easily even before diagnosis & no med prof has been able to explain why. I bruise even more easily since being on prednisolone though. I have many that I’ve no idea what caused them. Apart from folic acid there's nothing else I have in common with your meds.

Off subject, can I ask why you take folic acid?

ma73jon profile image
ma73jon in reply to nomoreheels

The nurse told me to continue with it even after the switch from Methotrexat to Leflunomide. Why I am not sure.

Brushwork profile image

I have been getting little groups of purple bruise like dots on my arms and legs for many years and have never been able to associate it with any medication. That leads me to believe that it is the RA.

wishbone profile image
wishbone in reply to Brushwork

I wouldn't rule out RA . If something as complexed as our immune systems are not functioning properly then who knows what ailments that can bring.

MaryTH profile image


I am the same though much older than you. The only medication I am on at the moment is Prednisone because of other medical conditions too numerous to mention. I only have to brush against something and have a bruise. My GP says it’s the steroids and in my case age.

Merry Christmas 🎄

TPaine profile image

Hi I would say it's the steroids causing this. In respect of your experience with RA being so active, would you be able to look at coming off the steroids to then get your 'real' DAS score? Maybe discuss with the rheumo nurse?

I only say this because when I was really struggling and was desperate for a steroid jab the nurse explained that to get the biologic approved it would be better to stay with the level of active problems if I could bear it as this will then show the full picture. It worked and I then got put on benepali, which has been a life changer for me. Something to think about maybe, otherwise you may be stuck as you are which sounds horrible.

Good luck and take care


sylvi profile image

It is called tissue skin as the drugs cause your skin to thin.xxxx

holly-willow profile image

I also have these bruises on my legs and there are lots of them. I never get much of an answer from GPs or rheumatologists except for them to say it is "probably the steroids and your skin thinning". I am in a wheelchair and it seems like every time I get in or out of it and just brush up against the foot rests that I get another bruise.

Troygirl profile image

I have been on prednisone for almost a year. Many months high doses up to 30mg!

I would get a bruise with the slightest bump!

It was getting so bad in the summer wearing summer cloths, people at work were probably thinking I was getting beatings!

It's definitely the Pred. It causes skin thinning, bone thinning, bruises and cataracts. I've been on them for years to treat Vasculitis, and will be on them indefinitely. Highest dose was 40mg a day. Now on 5mg,

IslandLife53 profile image

Hi! I totally empathize with you! On top of everything else; the bruising is like adding insult to injury! My bruising, which can also occur out of nowhere, started when I started MTX approximately 25 years ago. I immediately phoned my dermatologist (had not been diagnosed with PsA yet). He informed me that spontaneous bruising was a side effect of the MTX. I would try to hide them with band-aids but whenever I would attempt to remove the bandaid; more bruises would appear!! Still do! I’ve used Arnica bruise products, body makeup, applying ice immediately....all to no avail. I’ve prayed for a graceful acceptance of, yet, another challenge.

I wish a magic wand could make them disappear! This is when one must learn to be patient with yourself. You, take care and remember that the bruising does not define who you are.

Best Wishes!

ma73jon profile image

Thanks to all of you. Tracy, I am thinking carefully about giving up prednisolone in order to raise my DAS score in order to be eligible for a biologic. However this is quite frightening as I am worried the pain will then be completely unbearable. So I am turning this over in my mind. Many, thanks.

Bon1 profile image
Bon1 in reply to ma73jon

Good morning

If you have a good consultant then you should not have to undergo the barbaric “you’ve got to get worse and have us see it before we help” style ducking stool.

They can factor in the effect of the steroids and still present a case for biologics.

It might just be a case of you pushing for them. Good luck


lornaisobel profile image

I don't take any of the drugs you do apart from folic acid and i also get bruises i wouldnt think its the folic acid i just think its RA i will ask next time Im at a clinic if i remember also if I ever get another appointment havent seen a consultant or a rheumy nurse for nearly a year !!!

lKeith profile image


I have similar bruises it could be a mixture of your meds. Mine are largely due to a blood thinner. Check with your GP.


Bizzie profile image

My consultant stopped the hydroxychloroquine and even though I’m in blood thinners I have far less bruising.

LauraJM profile image

I bruise very easily and am only on MTX and folic so think it's RA rather than meds. I tend to get them when I've done a lot of repetitive movements, like my hand bruises after I've done a lot of chopping up veg!

ma73jon profile image

Many thanks to all of you again. I have now been told I qualify for a biologic and will be getting this soon. Let's see if this will remove the bruising problem as I will only be taking this with leflunomide.

KittyJ profile image
KittyJ in reply to ma73jon

Let’s hope so, my bruising stopped once I came off pred 🤞🏻

I was on prednisolone for a short time at the beginning and also got bruises which my Rheumy associated with that particular drug. Stopped happening once I went off it. But you should mention it to your dr to be sure

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