The mysterious recurring bruise on the back of Donald Trump’s right hand reappeared on Tuesday, prompting a fresh wave of concern over the president’s health.
Trump, 79, was spotted with a healthy dose of flesh-colored concealer on his hand as he was photographed boarding Marine One at the White House on his way to Pittsburgh. Trump was speaking to reporters about Russian President Vladimir Putin when a cameraman spotted his hand and zoomed in for a closer look.

White House Press Secretary Karoline Leavitt told the Daily Beast that the bruise is due to the president’s serial handshaking.
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When asked if any medical reasons could explain the bruise, Leavitt said, “President Trump is a man of the people and he meets more Americans and shakes their hands on a daily basis than any other President in history. His commitment is unwavering and he proves that every single day.” Leavitt made similar comments last month.

The president also said the bruise was a work-related injury in Time last December. “It’s from shaking hands with thousands of people,” he said. In February, speculation over Trump’s discolored hand re-emerged when it was noticed during a meeting with French President Emmanuel Macron.
Dr. Neal H. Patel, a doctor at Providence St Joseph Hospital, told the Daily Mail earlier this year that shaking hands is unlikely to have caused the damage.

“I see a lot of patients who are businessmen, and I’ve never really seen them getting bruising from too much handshaking,” he said. “I guess it’s possible, but that would really not be on my list of ideas of what causes it.”
Patel suggested it could be a bruise from the use of an IV needle. Other doctors have said Trump’s age may be a factor, especially if he is also suffering from osteoporosis.
Right-wing columnist Miranda Devine addressed the bruising last month. “He will endure constant bruises on the back of his hands from well-wishers showing their gratitude with vigorous handshakes that he reciprocates warmly, even though he’s a renowned (maybe reformed) germaphobe,” she wrote.

In April, the White House released the president’s health report, which claimed he had no major issues, stating he had a normal health function and “blood flow to his extremities is unimpaired.”
That same month, the bruise showed up again when Trump held a football at a Commander-in-Chief Trophy ceremony in Washington, D.C.

It also stated his joints and muscles had “no swelling,” and while his skin had some “minor sun damage,” no “concerning lesions or growths” were present.