Table 2. Differentiating livor mortis from a bruise.

^aThe color of a bruise will vary depending on the age of the bruise. It originally may be pinkish red, then darker blue or purple or black, then violet, then green, then dark yellow, then pale yellow (or yellow-brown or light brown).

^bIn contrast to indistinct border of developing livor mortis, the border of an acute bruise is usually well-defined.

^cThe results of the blanching test prior to livor mortis becoming fixed. The blanching test is performed by pressing a digit firmly on the affected area and observing whether blanching occurs.

^dThe findings on gross examination (regarding the absence or presence of hemorrhage) into the cut soft tissue after an incision with a scalpel blade has been made into the affected area. Faint erythema, resulting from the congested vessels, may be observed after an incision into livor mortis; hemorrhage into the soft tissue is absent.

^eThe microscopic findings of a bruise depend on the age of the bruise. An early bruise will show extravasation of red blood cells into the dermis and subcutaneous fat. Inflammatory cells will eventually also be present in the dermis including polymorphonuclear leukocytes (neutrophils) and macrophages. Eventually hemosiderin-laden macrophages will be noted. Hematoidin granules may subsequently be observed.

Characteristic	Livor mortis	Bruise	References
Colora	Purple to red	Purple to blue	[4,6,9,12]
Location	Dependent parts	Anywhere, often in prominent parts	[4,6,9,12]
Borderb	Indistinct	Well-defined	[4,6,9,12]
Local swelling	None, area flat	Present (accumulation of blood in area)	[4,6,9,12]
Depth in skin	Always superficial	Usually deep	[4,6,9,12]
Blanching testc	Area blanches	No blanching of area	[4,6,9,12]
Incision findingsd	No hemorrhage; faint erythema may be present	Diffuse hemorrhage into soft tissue	[4,6,9,12]
Microscopic findingse	Erythrocytes in vessels	Erythrocytes in dermis, subcutaneous fat or both	[4,6,9,12]