Solar purpura
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Solar purpura, also known as actinic purpura or senile purpura, is a common condition characterized by the appearance of purple or red bruises on the skin, particularly on areas exposed to the sun, such as the forearms and hands. This condition is most frequently observed in elderly individuals due to the thinning of the skin and the fragility of blood vessels.
Pathophysiology
Solar purpura occurs when the small blood vessels under the skin, known as capillaries, become fragile and rupture easily. This fragility is often a result of chronic sun exposure, which leads to the degradation of collagen and elastin fibers in the dermis. As a result, even minor trauma can cause blood to leak into the surrounding tissues, leading to the characteristic purplish discoloration.
Clinical Presentation
Patients with solar purpura typically present with:
- Irregularly shaped, flat, purple or red patches on the skin.
- Lesions that are usually painless and do not itch.
- Bruises that fade over a period of 1 to 3 weeks, often leaving a brownish discoloration due to hemosiderin deposition.
Risk Factors
Several factors increase the risk of developing solar purpura, including:
- Advanced age
- Prolonged sun exposure
- Use of corticosteroids, which can thin the skin
- Certain medications, such as anticoagulants
Diagnosis
The diagnosis of solar purpura is primarily clinical, based on the appearance of the lesions and the patient's history. In most cases, no further testing is required. However, if the presentation is atypical, a skin biopsy may be performed to rule out other conditions.
Management
There is no specific treatment for solar purpura, but management focuses on prevention and minimizing further damage:
- Avoidance of sun exposure and use of sunscreen
- Protective clothing to shield the skin from trauma
- Moisturizers to improve skin hydration
Prognosis
Solar purpura is a benign condition and does not lead to serious health problems. However, it can be cosmetically concerning for patients.
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