Merck Manual

Please confirm that you are a health care professional

honeypot link

Senile Purpura

By

David J. Kuter

, MD, DPhil, Harvard Medical School

Reviewed/Revised May 2023
View PATIENT EDUCATION
Topic Resources

Senile purpura causes ecchymoses and results from increased vessel fragility due to connective tissue damage or atrophy in the dermis caused by chronic sun exposure, aging, and drugs.

Purpura refers to purplish cutaneous or mucosal lesions caused by hemorrhage. Small lesions (< 2 mm) are termed petechiae, and large lesions are termed ecchymoses or bruises.

Senile purpura typically affects older patients as their dermal tissues atrophy and blood vessels become more fragile. Patients develop persistent dark purple ecchymoses, which are characteristically confined to the extensor surfaces of the hands and forearms. New lesions appear without recognized trauma and then resolve over several days, leaving a brownish discoloration caused by deposits of hemosiderin. This discoloration may clear over weeks to months or may be permanent. The skin and subcutaneous tissue of the involved area often appear thinned and atrophic.

Medications (eg, corticosteroids, warfarin, aspirin, clopidogrel) may exacerbate the ecchymoses.

No treatment hastens lesion resolution or is needed. Although cosmetically displeasing, the disorder has no health consequences and does not herald severe bleeding elsewhere.

Drugs Mentioned In This Article

Drug Name Select Trade
Coumadin, Jantoven
Anacin Adult Low Strength, Aspergum, Aspir-Low, Aspirtab , Aspir-Trin , Bayer Advanced Aspirin, Bayer Aspirin, Bayer Aspirin Extra Strength, Bayer Aspirin Plus, Bayer Aspirin Regimen, Bayer Children's Aspirin, Bayer Extra Strength, Bayer Extra Strength Plus, Bayer Genuine Aspirin, Bayer Low Dose Aspirin Regimen, Bayer Womens Aspirin , BeneHealth Aspirin, Bufferin, Bufferin Extra Strength, Bufferin Low Dose, DURLAZA, Easprin , Ecotrin, Ecotrin Low Strength, Genacote, Halfprin, MiniPrin, St. Joseph Adult Low Strength, St. Joseph Aspirin, VAZALORE, Zero Order Release Aspirin, ZORprin
Plavix
View PATIENT EDUCATION
NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
quiz link

Test your knowledge

Take a Quiz! 
iOS ANDROID
iOS ANDROID
iOS ANDROID
TOP