### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi My brother is 23 years old. About 5 days ago he got a bruise that suddenly appeared on on his forearm. He can t recall any bump. It started small with a blue/black coulour, but it s getting bigger and bigger. It now has a wine red colour with a white sircle about the size of a 20c coin in the middle. He says that the bruise and the white sircle are not sore at all, rather dead. When you press with your finger on the bruise it doesn t make a white sircle like when you press with you finger on your skin. There is no sign of any insect bit. The white area started with a lump, but is now flat after about 5 days. He says that he is very tired and that his muscles are sore. He also is experiencing back pains and a weird feeling in the back of his head. He says that it feels as if a vein is going to pop in his head. Yesterday there were 3 bubbles in the vain just next to the bruise on his arm. He is also confused and can t remember things, almost like blackouts. Please tell me what this can be and what the causes can be? Regards

### output:

Hi, Welcome to Chat Doctor virtual Clinic. Causes of the Bruises on the arm with 3 small lumps-As the bruise on your 23 yr old brother came 5 days back abruptly, without any previous history of any lump, and as it is getting bigger with wine red color changed from blue /black, with veins nearby engorged, with muscle soreness and debility, with disappearance of white central lump in 5 days time, with back pains and weird headache with blackouts, raises many queries about the lump being mostly of infective origin, or could it be any silent malignant melanoma? Or could it be Ringworm infestation?It's very difficult to comment on such a background unless direct physical examination from a Dermatologist /or a Surgeon with verification blood tests confirm it after Second Opinion on such a weird lump. So Second Opinion on this bruised lump on the arm with 3 small lumps of your brother, is suggested to you. Hope this reply would help you to plan treatment with your doctors. Will appreciate hitting thanks and review writing, to help needy patient visitors to Chat Doctor. Welcome for any further query in this regard. Good day. Chat Doctor. N. Senior Surgical Specialist.