The medication betamethasone can have the adverse effect of causing ecchymosis. Raccoon eyes may be accompanied by Battle's sign, an ecchymosis behind the ear. The injury can be accompanied by swelling and ecchymosis. The most common symptoms are pain, swelling, erythema, and ecchymosis. Bite symptoms include massive tissue swelling, pain, ecchymosis, hemorrhagic blebs, and necrosis. In the case of severe deficiency, there may be spontaneous gingival bleeding, ecchymosis, and epistaxis. Patients may develop periorbital ecchymosis ("raccoon eyes"). Patients with KHE and Kasabach-Merritt Phenomenon present with petechiae and ecchymosis. Coagulopathies such as Hemophilia A may cause ecchymosis formation in children. Envenomation can cause pain, swelling, hemorrhagic bleb formation and ecchymosis ("i.e.", bruising). An ecchymosis is a hematoma of the skin larger than 10mm. Symptoms may include visible discoloring (ecchymosis), breast pain, and swelling.