Background: Bateman purpura is characterized by diffuse senile skin atrophy, senile purpura and spontaneous stellar pseudocicatrices. Cutaneous changes in the course of ageing have been related to lower levels of ascorbic acid into the dermis of elderly people. Objective: In this study, we postulate that senile purpura could be linked to dermal vitamin C deficiency and could be corrected by topical administration of this vitamin. Methods: A weeks, hemi-member forearm or leg , randomized double-blind comparative study was conducted in 18 patients with Bateman purpura aged over than 60 years. At each visit, clinical assessment and biometrological measurements were performed.
|Published (Last):||5 October 2005|
|PDF File Size:||17.80 Mb|
|ePub File Size:||2.63 Mb|
|Price:||Free* [*Free Regsitration Required]|
Mature skin is prone to bruising, resulting in a condition known as actinic purpura, characterized by unsightly ecchymosis and purple patches. Similar to other skin conditions, the incidence of actinic purpura increases with advancing age and occurs with equal frequency among men and women. The unsightly appearance of actinic purpura may be a source of emotional distress among the elderly. A new product has been formulated specifically for the treatment of actinic purpura.
The objective of this paper is to review the beneficial properties of these ingredients and their respective roles in the treatment of actinic purpura. Although not a serious condition, its unsightly appearance is a significant cause of anxiety and the principle available treatment has been reassurance that the lesions will eventually resolve.
The goal of this paper is to briefly review actinic purpura and describe a new product specifically developed for the treatment of actinic purpura and the prevention of future lesions. Skin aging is a complex process associated with cumulative DNA damage 1 due to intrinsic factors, such as the action of reactive oxygen species, 2 and exogenous factors including exposure to ultraviolet light.
In addition, the incidence of skin disorders increases with age. These included solar lentigines, senile angiomas, xerosis, seborrheic keratoses, varicose veins, and pruritus. In the United States, it is estimated that the number of people 65 and older will double from 41 million in the year to 86 million by the year Mature skin is often prone to significant bruising due to reduction in connective tissue, loss of subcutaneous fat to support the skin structure, flattening of the dermal junction, and effacement of the dermal papillae.
The connective tissue of the dermis is no longer able to adequately support the microvasculature. Consequently, minor trauma can rupture blood vessels, leading to extravasation of blood.
This age-related condition is called actinic purpura. Actinic purpura occurs almost exclusively among the elderly population, although it may occasionally occur in younger people.
One source suggests actinic purpura affects approximately two percent of people 60 to 70 years old, increasing to as many as 25 percent of people in the to year age group. Another suggests actinic purpura affects less than 10 percent of people over 50 years old. It is closely associated with photoaged skin 15 and may be worse among people taking aspirin, nonsteroidal anti-inflammatory drugs, or anticoagulants.
Treatment is usually unnecessary and complications are rarely reported. Post-inflammatory hyperpigmentation may occur.
The consequences of photodamaged skin include increased rhytides, pigmentary changes, skin laxity and roughness, and telangiectasias, which may have a negative impact on overall quality of life including interpersonal interactions and self-esteem.
Published work describing available treatments for actinic purpura are limited. Subjects were randomized to receive twice-daily treatment with 0. This product contains ingredients that effectively treat actinic purpura by improving local circulation, thickening the skin, and repairing the skin barrier.
Each of these ingredients and their known beneficial effects are described in detail below. Numerous studies have demonstrated the beneficial effects of topical retinol, a precursor of retinoic acid. In one study, retinol 0. This treatment increased epidermal thickness, and upregulated genes for collagen type 1, and collagen type 3 with corresponding increases in procollagen I and procollagen 3 protein expression and a significant reduction in facial wrinkles.
A week, double-blind, vehicle-controlled study demonstrated the ability of a retinol 0. When combined with a vitamin C-containing moisturizer, the application of topical retinol 0. While no study has assessed the effects of retinol for the treatment of actinic purpura, the combination of topical 0. Alpha hydroxy acids. DerMend contains glycolic compound 4. In vitro studies have shown that dermal fibroblasts grown in the presence of glycolic acid for 24 hours resulted in increased collagen production.
Arnica oil. Arnica oil is derived from the medicinal plant Arnica montana L. Extracts of A. The barrier function of the stratum corneum is dependent on the presence of a lipid matrix that includes the epidermal sphingolipid ceramides. Using an in vitro model, the effects of the ceramides phytosphingosine, sphingosine, sphinganine and their hexanoyl-, stearoyl- and salicyl-derivatives were assessed using human keratinocytes.
Improvements in skin barrier function have been demonstrated following the topical application of physiologic amounts of the ceramides sphingosine, phytosphingosine, esterified fatty acids, omega hydroxy fatty acids, normal fatty acids, and alpha-hydroxy fatty acid in human volunteers.
A controlled clinical trial assessed the beneficial effects of a ceramide 3-containing emollient using an experimental skin barrier dysfunction model in healthy volunteers. Half the injured areas were treated once daily with the test product for five days. On Day 4, the ceramide-containing emollient significantly decreased erythema, transepidermal water loss, and cycling cells vs. Niacinamide or niacin is a form of vitamin B3 with antioxidant properties that help improve skin appearance.
It regulates poly-ADP ribose-polymerase 1, an enzyme with important roles in DNA repair and the expression of inflammatory cytokines. The application of niacinamide can also improve the appearance of fine lines and wrinkles, 45 , 46 hyperpigmentation spots, texture, red blotchiness, and sallowness. Significant improvements in skin appearance included reduction in fine lines and wrinkles, hyperpigmented spots, red blotchiness, sallowness, and skin elasticity.
Interestingly, oral nicotinamide has recently been shown to be effective for reducing nonmelanoma skin cancers and actinic keratoses in high-risk patients. Topically applied phytonadione, or vitamin K1, has been shown to have beneficial effects on injured skin.
Using an animal model, a topical vitamin K cream increased experimental wound healing. In a similar randomized, controlled study, the application of vitamin K gel following pulsed dye laser treatment shortened the time for resolution of facial bruising. My personal observation is that DerMend is very effective for the treatment of actinic purpura. I recommend that patients treat their hands and forearms where sun damage is more pronounced and where the skin is thinner and skin injury is more likely to occur.
For some patients, this may also include the lower legs. The product should be applied to all areas twice daily to improve skin quality and prevent or minimize future lesions and three times daily on bruised areas to improve healing.
The appearance of actinic purpura left is greatly improved after treatment for 56 days right. The appearance of actinic purpura left is greatly improved after treatment for 26 days right. National Center for Biotechnology Information , U. J Clin Aesthet Dermatol. Roger I. Ceilley , MD.
Author information Copyright and License information Disclaimer. Corresponding author. Author correspondence: Roger I. Ceilley, MD; E-mail: moc. Disclosure: The author acknowledges the editorial assistance of Dr. Carl S. Hornfeldt, Apothekon, Inc. Matrix Medical Communications. All rights reserved.
Abstract Mature skin is prone to bruising, resulting in a condition known as actinic purpura, characterized by unsightly ecchymosis and purple patches. Open in a separate window. Figure 1. Figure 2. Yaar M, Gilchrest BA. Skin aging: postulated mechanisms and consequent changes in structure and function. Clin Geriatr Med. Intrinsic skin aging: the role of oxidative stress. Acta Dermatovenerol Alp Pannonica Adriat.
Ultraviolet radiation-induced skin aging: the role of DNA damage and oxidative stress in epidermal stem cell damage-mediated skin aging. Stem Cells Int. Skin health in older age. Skin diseases associated with the depletion of stratum corneum lipids and stratum corneum lipid substitution therapy. Skin Pharmacol Physiol. Kaya G, Saurat JH. Clinicopathological features, mechanisms, prevention and potential treatments.
Functional and physiological characteristics of the aging skin. Aging Clin Exp Res. Beauregard S, Gilchrest BA. A survey of skin problems and skin care regimens in the elderly. Arch Dermatol. Common skin disorders of aging: diagnosis and treatment. Skin disorders in elderly subjects.
Int J Dermatol. Kochhar R. Ten projections for the global population in Topical human epidermal growth factor in the treatment of senile purpura and the prevention of dermatoporosis. J Drugs Dermatol.
Senile purpura causes ecchymoses and results from increased vessel fragility due to connective tissue damage to the dermis caused by chronic sun exposure, aging, and drugs. See also Overview of Vascular Bleeding Disorders. Purpura refers to purplish cutaneous or mucosal lesions caused by hemorrhage. Senile purpura typically affects older patients as their dermal tissues atrophy and blood vessels become more fragile.
What to know about senile purpura
DermNet provides Google Translate, a free machine translation service. Note that this may not provide an exact translation in all languages. February Senile purpura is a common, benign condition characterised by the recurrent formation of purple ecchymoses bruises on the extensor surfaces of forearms following minor trauma.
Treatment of Actinic Purpura
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. 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.