Senile purpura: Causes, symptoms, and diagnosis
Fair skinned older people are more likely to develop the condition. It is characterized by oddly shaped discolored areas on exposed skin, usually on the arms and hands.
What is senile purpura?
Image credit: José Reynaldo da Fonseca, 2013
The discolored spots of senile purpura have also been called blood spots or skin hemorrhages.
The initial signs of senile purpura are purple or red bruises that have an irregular shape. The bruises are not the result of bleeding disorders, a lack of vitamins or minerals, or a sign of a significant injury.
Small bruises are known as petechiae, and larger ones are called ecchymoses. The colors will usually not darken or lighten much as the spots progress. After the bruise has healed, however, a yellow or brown stain might remain on the skin.
Senile purpura itself is not harmful, but it may be a sign of an underlying condition.
Causes and risk factors
Aging skin is thought to be the most common cause of senile purpura. As the body ages, the skin becomes thinner and more delicate.
Over time, exposure to ultraviolet (UV) rays weakens the connective tissues that hold the blood vessels in their place. This weakness makes the blood vessels fragile, which means that even after a minor bump, red blood cells can leak into the deeper layers of the skin, causing the distinctive purpura to appear.
Senile purpura occurs most frequently in older adults, but normal aging is not the only source of this kind of skin damage. The skin's aging process may accelerate if a person has spent extended periods of time in UV light.
People who take certain drugs, such as blood thinners or steroids, on a regular basis may be more likely to experience purpura. Non-steroidal anti-inflammatory drugs (NSAIDs) may also contribute to the condition.
Some vascular diseases that affect collagen in the body, such as lupus, rheumatoid arthritis, and Sjogren's syndrome, can also cause purpura. Purpuras can also be a side effect of some cancers, including lymphoma and leukemia.
Thrombocytopenia, which is a deficiency in blood platelets, can cause bleeding and bruising in the dermis similar to senile purpura.
Other possible causes include:
Exposure to ultraviolet rays and aging skin are common causes of senile purpura.
- chronic stasis
- fragile blood vessels
- blood clotting disorders
- pressure changes during childbirth
- trauma and injuries
- anticoagulant therapy
- systemic disease
- TORCH infections
Senile purpura may also be a sign of collagen loss in the skin and bones. Doctors may see the loss of collagen in the skin as an indication that the person is experiencing a similar reduction in bone health.
The symptoms of senile purpura most commonly occur on the exposed parts of the skin, such as the arms, hands, or top of the head. Older adults who bleed very easily tend to experience purpura more often.
The most noticeable symptoms are the distinct reddish purple spots that appear on the body and keep recurring over an extended period.
Additional symptoms include:
- thin skin
- loose skin that lacks elasticity
- skin that tears easily
- purpura that occur without injury
The bruises caused by senile purpura typically last between 1 and 3 weeks before fading. After the bruise is gone, discoloration may remain at the site for a long time.
A CBC test may be common to help diagnose senile purpura, alongside other tests.
Doctors can usually diagnose senile purpura based on a visual examination alone. However, they will sometimes use tests to help them make sure the senile purpura is not caused by something more serious.
It is common to receive a complete blood count (CBC), as well as any number of more specific tests.
Other tests doctors may use include:
- urine tests to rule out blood in the urine
- liver function tests (LFT)
- cancer screening
- erythrocyte sedimentation rate or CRP tests to check for inflammation caused by vascular diseases
- renal function tests to eliminate renal diseases that cause purpura
Doctors may also do a test called a punch biopsy to check the skin and blood cultures.
Treatment and prevention
The body can usually heal itself from the bruises of senile purpura without any additional help. If the skin is especially thin, it may tear, causing a lesion at the site of the bruise. This cut can be treated in the same way as a regular cut.
It is also helpful to protect the skin from any further damage. Long-sleeved shirts and hats can help protect the skin from the sun, and people should try to avoid bumps and bruises as much as possible.
The bruises can be unsightly, and treating them can help improve the quality of life in the people who have senile purpura.
A study in the Journal of Drugs and Dermatology found success using an oral medication designed to treat and prevent senile purpura. Researchers noted that the treatment appeared to safely and effectively reduce bruises in people with senile purpura. The participants also felt that their skin looked and felt better when using the medication.
Dermatologists may recommend other medicines to people who are troubled by the sight of the bruises.
Senile purpura is not always preventable, but people can use sunscreen and protect their skin from sun damage as much as possible.
Sunscreens, long clothing, and hats will not reverse damage caused by sun exposure, but they can help prevent additional damage.
Senile purpura itself is not harmful. People should work with their doctor to diagnose and treat serious disorders if that is the cause of their bruising.
The bruises may be unsightly, and many choose to cover them while they heal. The bruises heal themselves in a few weeks but can leave lasting marks on the skin. Bruises usually come back throughout the person's life, and there is no known cure for senile purpura.
People who are uncomfortable with the appearance of senile purpura may contact a dermatologist for recommendations to heal and replenish the damaged skin.