Purpura senilis D69.2

Bateman, 1818

Purpura appearing at higher age in light-exposed body parts, s.a. Purpura factitia senilis.

Actinic and age-related, degenerative damage to the vessel walls and the surrounding collagenous connective tissue (this manifests itself mainly in a senile (actinic) elastosis) The bleeding usually occurs due to banal, acute shear forces of the skin and is correspondingly visible in mechanically exposed areas (extensor side of the lower arm, back of the hand).

Occurs in 5-15% of older adults, usually after the age of 60.

Chronically sun-exposed skin areas, especially the back of the hand and forearm extensor sides are affected.

0.1 cm - max. 3.0 cm in size, different, mostly bizarrely configured, sharply defined, reddish to blue-red, hemorrhagic spots in atrophic thin skin. Later caused by haemosiderin deposits, transition to brownish-red or brownish-yellow discoloration of the skin. S.a.u. Purpura cachectica, s.a.u. Purpura solaris.

Since the actinically severely damaged skin is subject to additional physiological involution with increasing age, there is a great danger of vulnerability. Here, the skin can peel off its support like a wet handkerchief.

Skin care with moisturising external agents (e.g. ash base ointment, linola fat, Exicipial U Lipolotio, Lipoderm). Avoidance of trauma. Light compression therapy to support the lower legs ( compression stockings class I to II). If necessary, light protection (e.g. Daylong 16 or Anthelios).

1. Bateman TA (1813) Exanthema. In: Practical Synopsis of Cutaneous Diseases. Longman, Hurst, Rees, Orme & Brown, London, S. 118-119