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| Fig. 59.4 Severe senile purpura on the dorsum of the hands and forearms of an elderly patient. |
These lesions, referred to as senile purpura (solar purpura, Bateman’s purpura, purpura senilis), are common. One study of patients over age 64 years found them in 9% of those examined. The lesions are characterized by sharply demarcated areas of purpura that typically measure 1 to 5 cm (Fig. 59-4). The associated skin is atrophic and inelastic. Patients typically report that these lesions are brought on by minor trauma. It is believed that they are secondary to UV damage to the fibroblasts surrounding the blood vessels, which results in the loss of normal supporting collagen. The role of solar damage is supported by case reports of lateralization of solar purpura to one arm that receives more sunlight (e.g., left arm of a taxicab driver).
Joshi RS, Phadke VA, Khopar US, Wadhwa SL: Unilateral solar purpura as a manifestation of asymmetrical photodamage in taxi drivers,
Arch Dermatol 132:715–716, 1996.
