Pope Francis appeared with a bruise on his chin at the ceremony where he named 21 cardinals

Pope Francis led a ceremony at St. Peter’s Basilica on Saturday to install 21 new Catholic cardinals with a large bruise on his chin, which the Vatican said was the result of a minor fall the previous morning.

Francis, who turns 88 this month, appeared in good shape, leading a ritual-filled ceremony to elevate ecclesiastics from 17 countries to the College of Cardinals, the elite group that will one day choose his successor.

A purplish stain could be seen on the right side of the Pope’s face.around the bottom of the chin and the top of the neck. The Vatican press office said Francis had hit his chin on his nightstand on Friday morning.

Francis, pope since 2013, has suffered occasional bouts of ill health in recent years, and now uses a wheelchair due to knee and back pain.

The cardinals are, along with the Pope, the highest officials of the Catholic Church, which has 1.4 billion faithful.

Upon the death or resignation of the pontiff, the cardinals under 80 years of age are in charge of entering a conclave and electing the next Pope.

Francis has already named about 80% of the prelates who will choose the next pope, increasing the likelihood that the next pontiff will share his vision of a more inclusive Church committed to the rest of the world.

At least 67 countries now have cardinals who can vote in a conclave, according to Vatican statistics, compared with fewer than 50 when Francis was elected. The new cardinals come from countries such as Peru, Argentina, Japan, the Philippines, Algeria, India and Serbia.

In his homily on Saturday, Francis said the new cardinals “come from different origins and cultures,” and urged them to be “witnesses of fraternity, architects of communion and builders of unity.”

Archbishop Ignace Bessi Dogbo, one of the new cardinals, praised the pope’s efforts to boost geographic diversity.

“Having cardinals from all parts of the world truly translates the universality of the Church,” Bessi Dogbo, a native of Abidjan, Ivory Coast, told Reuters.