Senile purpura are small bruises that occur in the elderly due to increased fragility of blood vessels and other age—related changes in the structure of the skin. Predisposing factors include the influence of ultraviolet radiation, anticoagulant therapy. The disease is manifested by bruises, which are usually located on the hands and appear for no apparent reason. Diagnosis of this type of purpura is based on a physical examination. To exclude other causes of vascular disorders, a coagulogram, clinical blood tests are prescribed. Pathology does not require treatment, but heparin ointments are recommended to reduce unaesthetic spots.
D69.2 Other non-thrombocytopenic purpura
Senile purpura is a typical problem of the elderly, which occurs on average in 80% of people over 60 years old. Women get sick more often than men, people with low weight suffer from this form of purpura more often than overweight patients. The disorder does not pose a threat to health, but is manifested by visible aesthetic defects and causes discomfort in patients. Often the pathology is combined with other senile dermatoses: lentigo, chronic actinic dermatitis, seborrheic keratosis.
Senile purpura is caused by natural age-related changes, appears without traumatization of the skin or with minor exposure, for example, regular rubbing with clothes or careless touches. The main predisposing factor is called chronic exposure to ultraviolet light, so bruising is more often observed in open areas of the body. The development of the disease is facilitated by the use of anticoagulants, antiplatelet agents, glucocorticoids.
With age, a number of adverse changes begin in the skin, which are caused by two mechanisms: natural processes of “programmed death” of cells, negative external influences throughout life. Under the influence of these factors, degeneration of connective tissue fibers of the dermis and vascular walls occurs, the skin becomes thinned, similar to parchment.
As we age, the barrier properties of the skin deteriorate, their hydration decreases, and the secretion of sebaceous glands decreases. These changes, together with the increased fragility of blood vessels, contribute to frequent damage to capillaries, the formation of bruises. The problem is more pronounced in elderly patients with a thin build, since they do not have a sufficient layer of subcutaneous tissue that performs the function of depreciation.
Senile purpura symptoms
The condition is manifested by spot hemorrhages in the skin (petechiae) and larger foci of several centimeters in size (ecchymoses). As a rule, purple spots form on the hands and forearms, legs and trunk are rarely affected. Bruises lighten within a few days, leaving behind peeling, persistent brown pigmentation. In places of the characteristic appearance of senile bruises, the skin looks thinned, atrophic.
The disease is not accompanied by blood clotting disorders, does not cause life-threatening hemorrhages and bleeding. The main problem of senile purple is a cosmetic defect on the visible areas of the body, which causes significant discomfort to a person, makes him pick up completely closed clothes with long sleeves even in the hot season. With a prolonged course of the disease, cutaneous hemosiderosis is formed, characterized by a favorable course.
A clinical assessment of skin changes is carried out by a general practitioner, and a consultation with a hematologist may be required to clarify the diagnosis. At the initial appointment, the specialist asks the patient about the medications taken, identifies typical symptoms of senile dermatoses. The condition of the capillaries is assessed using a pinch or tourniquet test. An additional examination is prescribed to exclude more serious causes of purpura, and includes the following methods:
- Coagulogram. Indicators of prothrombin time, APTT, fibrinogen are within normal limits. An increase in blood clotting time is often detected, which is associated with the appointment of systemic anticoagulants to the elderly.
- Hemogram. With senile bruises, the number of platelets remains normal, mild anemia is possible due to chronic pathologies and frequent bruising. Deviations in the biochemical analysis are caused by concomitant diseases.
Senile purpura treatment
There is no specific etiopathogenetic therapy. To accelerate the resorption of bruises, prevention of cutaneous hemosiderosis, ointments with anticoagulants are prescribed. An important role is played by sufficient nutrition of the skin, which increases its elasticity and resistance to mechanical damage. Elderly patients are selected lines of dermatocosmetics with the addition of hyaluronic acid, collagen, and nourishing oils.
Prognosis and prevention
Sufferers of senile purpura do not have severe complications, so the prognosis for patients is favorable. Prevention consists in regular skin care, the use of nourishing creams, the application of products with a high level of SPF on days with an increased UV index. Minor hemorrhages with normal markers of hemostasis are not grounds for the cancellation of anticoagulant therapy prescribed by a cardiologist.