Senile Purpura
Author: Faiza Rashid
Chief Editor: Dr Daniel Keith
What is Senile Purpura?
Senile purpura (AKA Bateman purpura, as described by Bateman in 1818) is characterised as recurrent dark purple ecchymoses (bruising) found on the extensor surfaces. It is most commonly found in elderly patients due to their increased skin fragility which can increased the likelihood of connective tissue atrophy. It has been associated with chronic sun exposure and aging. Certain medications which are incidentally more common in an elderly age group such as warfarin, aspirin and clopidogrel can aggravate the ecchymoses. Although senile purpura can appear quite harsh to the naked eye, it does not require any immediate intervention and does not indicate bleeding elsewhere in the body or cancer of any sort, so healthcare professionals can be reassured when presented with very common cases of senile purpura.
Macroscopic Appearance
Macroscopically, we can see that senile purpura presents as irregularly shaped dark-purple macules due to extravasation of blood and this is because of haemosiderin deposition which adds to the pigment. We can see that the surrounding skin is generally thin and has other patches of hyperpigmentation indicative of prior sun damage and a history of chronic sun exposure, which patients with senile purpura often do have, further affirming our diagnosis.
Figure 1a
Figure 1b
Dermoscopic Appearance
Dermoscopially, we can see that senile purpura (particularly in figure 2a) presents as a homogenous, irregular, purpuric and purple patch. We can see telangiectasia in 2b, again perhaps more notable in an elderly population, further reaffirming our diagnosis. We can see the borders are not very well-defined which is typical of senile purpura, and this is evidenced on both figures 2a and 2b below, as the patches cannot be well demarcated. In figure 2b, we can note that there is evidence of yellow pigmentation, again indicating previous sun exposure / history of chronic sun exposure, fitting the diagnosis of senile purpura and reassuring us further.
Figure 2a
Figure 2b