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Updated: Dec 17 2021

Senile Purpura

  • Snapshot
    • A 68-year-old woman is bothered by easy bruising. She recalls that even reaching into her purse can cause bruising along the sides of her arms. These bruises resolve on their own, but they bother her cosmetically. She is otherwise healthy and is not taking any medications.
  • Introduction
    • Non-inflammatory purpura presenting as ecchymotic lesions on sun-damaged skin
    • Also known as actinic purpura or solar purpura
    • Associated with
      • sun exposure
      • anticoagulants
      • corticosteroids
  • Epidemiology
    • Seen in patients > 65 years of age
      • dermal tissue atrophy
      • blood vessel fragility
  • Presentation
    • Symptoms
      • easy bruising with minimal or no trauma
      • heals on its own
    • Physical exam
      • non-palpable, purple bruises
      • fade to brown (hemosiderin deposits)
      • commonly on sun-exposed skin
        • forearms
        • dorsal hands
  • Evaluation
    • Diagnosis made by clinical history and exam
  • Differential
    • Solar lentigo
    • Geriatric abuse
  • Treatment
    • None
  • Prognosis
    • Purpura may resolve after weeks
    • Residual hyperpigmentation (brown color) may remain
    • No other health consequences
    • No indication of severe bleeding elsewhere
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