It usually affects elderly individuals and is characterized by dark purple blotches on photo-exposed . Actinic purpura is believed to be more common in men. disorders and infections that cause abnormalities in blood vessels or blood production, blood vessel deterioration associated with age, infectious or inflammatory diseases that affect the blood vessels, some drugs, such as steroids and sulfonamides, low platelet count, which may lead to increased bleeding after an injury, bleeding gums or nose, or blood in urine or bowel movements, sore, swollen joints, particularly in the ankles and knees, kidney problems, particularly protein or blood in the urine. Other causes of nonthrombocytopenic purpura can include: allergic vasculitis. It most commonly affects children between, A contusion is the medical term for a bruise. Other topical agents such as vitamin C and K, have been tried with limited reported benefits. 1989;43:498501. Purpura is purple spots or patches on your skin or in your mucus membranes (such as your mouth and throat). ), Lawrence, N. New and emerging treatments for photoaging. [48], Phytonadione. Bruises usually come back throughout the persons life, and there is no known cure for senile purpura. Actinic purpura is a common benign disorder of dermal connective tissues due to skin damage from chronic sun exposure. 1996. pp. They predominantly treat thrombocytopenic purpura and patients who do not respond to corticosteroids. 1988;124:2425. Cutis. Half the injured areas were treated once daily with the test product for five days. Cutaneous and psychosocial benefits of alpha hydroxy acid use. In one study, retinol 0.1% was applied to the skin of healthy women 35 to 55 years old (N=41) every other day for two weeks, then daily for 10 additional weeks. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada)dedicated to using leading-edge science to save and improve lives around the . 38. He healed well post-peratively and did not experience new tears,brusing or trauma to the grafted location after 15 months. Ceramides. Purpura occurs when small blood vessels burst, causing blood to pool under the skin. (Results showed a significant increase in elasticity and firmness in the treatment group. Palpable purpura is purpura than can be felt, due to inflammation of the blood vessels ( vasculitis) It is closely associated with photoaged skin[15] and may be worse among people taking aspirin, nonsteroidal anti-inflammatory drugs, or anticoagulants. Interestingly, oral nicotinamide has recently been shown to be effective for reducing nonmelanoma skin cancers and actinic keratoses in high-risk patients. Aging skin is thought to be the most common cause of senile purpura. Copyright 2017, 2013 Decision Support in Medicine, LLC. Learn more about a low eosinophil count, including symptoms, possible causes, and treatment options. 968-76. Leu S, Havey J, White LE, et al. Sunburn purpura remains a rare phenomenon in which a petechial or purpuric rash develops acutely after intense sun exposure. 2022 JCAD | The Journal of Clinical and Aesthetic Dermatology. Some vascular diseases that affect collagen in the body, such as lupus, rheumatoid arthritis, and Sjogrens syndrome, can also cause purpura. Patients who experience purpura with any of the following symptoms should seek medical treatment: The spots of purpura are fairly easy to tell apart from other rashes. side effects of some medications like steroids or sulfonamides . [36] Ceramides also play a role in the differentiation of keratinocytes and regulation of cell signaling. 5. J Dermatol. Arch Dermatol. blood clotting issues caused by medication or disease, infectious diseases, particularly among children and the elderly, poor nutrition when it leads to a lack of vitamin C, some forms of cancer, such as leukemia and myeloma, inflammatory conditions and disorders, such as. 2015;373:16181626. 8. The role of topical vitamin K oxide gel in the resolution of post-procedural purpura. Kornhauser A, Coelho SG, Hearing VJ. Any bruising or. As the body ages, the skin becomes thinner and more delicate. Effects of topical vitamin K and retinol on laser-induced purpura on nonlesional skin. Cutis. Because purpura can signal an underlying medical problem, it may lead to complications without treatment. 11. Solar purpura is often missed as a diagnosis as it takes only minimal sun exposure to cause the condition as a result of years or decades of blood vessel weakening. [11] Consequently, there will be a substantial increase in age-related dermatologic diseases and conditions in the future. Ceilley, R.I. (2017, June 1). 2012;21:3336. Craciunescu O, Constantin D, Gaspar A, et al. Steroid treatment can reduce kidney damage and abdominal pain. The bruises may be unsightly, and many choose to cover them while they heal. One should immediately consult a dermatologist to reduce their appearance. He would carry out a thorough examination of the patient. Learn more about, Purpura and petechiae are discolored spots of skin that result from leaking blood vessels. Bruising can happen more easily if a person uses certain medications or has a health condition or. Senile purpura itself is not harmful, but it may be a sign of an underlying condition. Effects of 0.1% retinoic acid on Batemans actinic purpura. Kucharekova M, Schalkwijk J, Van De Kerkhof PC, et al. Kurban RS, Kurban AK. She is otherwise healthy and is not taking any medications. 9. Extravasated blood usually breaks down and changes colour over a few weeks from purple, orange, brown and even blue and green. Solar purpura (senile purpura, actinic purpura) is a benign form of purpura related to sun exposure. Copyright 2023 Haymarket Media, Inc. All Rights Reserved. Berlin, J. M., Eisenberg, D. P., Berlin, M. B., Sarro, R. A., Leeman, D. R., & Fein, H. (2011, July). Last medically reviewed on August 6, 2017, Henoch-Schnlein purpura is an inflammation that causes the small blood vessels to leak, leading to a rash. Sunscreens, long clothing, and hats will not reverse damage caused by sun exposure, but they can help prevent additional damage. This can include options such as chemotherapy, antiviral drugs, steroid medications, antibiotics, and surgery. ), (Geriatric study of prognostic factors of senile purpura (SP) in 1125 elderly Chinese patients. Over time, they turn purple and darken a bit further before fading away. These bruises resolve on their own, but they bother her cosmetically. 8. Know the causes, signs, symptoms, treatment and prevention of solar purpura. 2015;54:e332e338. 2008;123:6974. Tfayli A, Guillard E, Manfait M, et al. 2017;10(6):4450. All rights reserved. Senile Purpura. McKnight B, Seidel R, Moy R. Topical human epidermal growth factor in the treatment of senile purpura and the prevention of dermatoporosis. 2012;57:343352. Unlike other rashes, purpura will not change color or blanch when pressed. The participants also felt that their skin looked and felt better when using the medication. 1987;123:16381643. Diseases that impair bone marrow function may restrict the bodys ability to make platelets, and attack bone marrow, such as: Small purple spots on the skin, typically 410 millimeters (mm) in diameter, characterize purpura. This common, benign, connective tissue/skin disorder was initially discovered by Bateman in 1818 and generally affects the elderly population. People should work with their doctor to diagnose and treat serious disorders if that is the cause of their bruising. Fair skinned older people are more likely to develop the condition. [51], Recommendations for the Treatment of Actinic Purpura. ), (In-depth review of the histologic changes, clinical changes, and treatments (including vitamin C, vitamin D, hormones and alpha hydroxy acids as mentioned above ) for photoaging. window.__mirage2 = {petok:"XDdNlP9erHuGDdO.iGoTAMx07i0RX4qZOG7kfTOZt3I-1800-0"}; Exp Dermatol. Int J Dermatol. Kaya G, Jacobs F, Prins C, et al. In the United States, it is estimated that the number of people 65 and older will double from 41 million in the year 2010 to 86 million by the year 2050. 2008;35:637642. Heart failure: Could a low sodium diet sometimes do more harm than good? Skin aging: postulated mechanisms and consequent changes in structure and function. Evaluation of antioxidant and cytoprotective activities of Arnica montana L. and Artemisia absinthium L. ethanolic extracts. Sort by: Most popular doctor view output CT scan. Researchers noted that the treatment appeared to safely and effectively reduce bruises in people with senile purpura. Senile purpura is a condition which is mostly seen in older adults. Purpura Simplex Bruising and Bleeding. Each of these ingredients and their known beneficial effects are described in detail below. Sharp abdominal pain which can intensify during a women's menstrual cycle. The doctor studies all symptoms and medical history of the patient and also undergoes a physical test. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://www.ncbi.nlm.nih.gov/pubmed/21720653, http://jcadonline.com/treatment-of-actinic-purpura/. Indian J Dermatol. [3] The skin becomes thinner and less elastic (solar elastosis),[4] and the barrier function of the skin decreases due to depletion of lipids in the stratum corneum. What is senile purpura benign condition characterised by the ecchymoses (bruises) on the extensor trauma. Topics AZ However, people may not like these patches or bruises on their skin so many seek treatment, which may include: Senile purpura does not have any serious complications as it is a benign condition. What causes actinic purpura?Actinic purpura results from sun-induced damage to the connective tissue of the dermis (deeper layers of the skin) combined with . About 10% of the people over the age of 50 years get affected by this. This site uses Akismet to reduce spam. Shah NS, Lazarus MC, Bugdodel R, et al. ), Lewis, AB, Gendler, EC. In initial stages, they are purplish red and appear as patches or spots on the skin. What causes purpura? The Licensed Content is the property of and copyrighted by DSM. This product contains ingredients that effectively treat actinic purpura by improving local circulation, thickening the skin, and repairing the skin barrier. vol. Senile purpura, also called actinic purpura, is a type of elderly skin bruising that doesn't result from serious trauma even though it may look like an injury occurred. Senile Purpura also termed as actinic purpura is a . However, they will sometimes use tests to help them make sure the senile purpura is not caused by something more serious. Also known as senile purpura,[12] solar purpura,[13] traumatic purpura, and Batemans disease,[14] it is characterized by unsightly ecchymoses and purple patches on the arms or legs of elderly persons caused by blood extravasation following minor trauma. Int J Cosmet Sci. Paragh G, Schling P, Ugocsai P, et al. [16] Following extravasation, blood is typically resorbed in 10 to 14 days. Here is an article about a product, Dermend, that is supposed to help with this. Solar purpura is more commonly known as senile purpura, but is also sometimes called actinic purpura or Bateman purpura. Results showed that fasting plasma zinc levels were lower in those with senile purpura, than those without. ), Shah, NS, Lazarus, MC, Bugdodel, R. The effects of topical vitamin K on bruising after laser treatment. vol. 41. Semin Cutan Med Surg. The clinical hallmark of LCV is palpable purpura: purpuric papules erupt symmetrically on the shins 7-10 days after an inciting factor. Van Scott EJ, Yu RJ. Older individuals have thinner, more fragile skin, so bruises are more likely to form as a result. Skin Pharmacol Physiol. 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 90- to 100-year age group. Age Ageing. ), (Reviews treatments for the aging skin; includes a discussion on vitamin C and topical hormone therapy. The main symptom of purpura is a purplish-red rash beneath the skins surface. Senile purpura Stock Photos and Images. However, the discoloration might be permanent even after the lesions fade away causing a brown patch in the affected area. Purpura What are some potential causes of low eosinophil levels? They do not occur from any deficiency of vitamins or minerals, neither because of any bleeding disorders. Chapter Contents Actinic Purpura Disseminated Intravascular Coagulation [23], While no study has assessed the effects of retinol for the treatment of actinic purpura, the combination of topical 0.3% retinol and 1% vitamin K shortened the duration of laser-induced purpura when applied for two weeks prior and two weeks after undergoing treatment with a pulsed dye laser. Solar purpura is a common skin disorder characterized by easy bruising and the appearance of flat, purple bruises. Purpura is nonblanchable because the blood is extravasated outside the vessel walls. Despite being a benign condition, the continual development of purpura lesions in afflicted patients is frequently a source of significant visual and social concern. 2008;17:10041016. Prednisone causes the blood vessel walls to become very fragile. Purpura may resemble a bruise or look like a spot of blood under your skin. Suction bruise Some hyperpigmentation may remain after the purpura resolves. However, they can also signify severe medical conditions such as immune disorders and infections. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Who is at Risk for Developing this Disease? Doctors may see the loss of collagen in the skin as an indication that the person is experiencing a similar reduction in bone health. Patients develop persistent dark purple ecchymoses . As a result, the dermis thins tremendously and there is less cushioning around the vasculature. Carbuncle is a skin infection that is characterized by red colored swollen and dome-shaped cluster of boils involving a group of hair follicles. It's sometimes called actinic purpura. Petechiae are usually present in thrombocytopaenic purpura. Solar Purpura - (also known as "Actinic purpura," and "Senile purpura") is a skin condition characterized by large, sharply outlined, 1 - 5cm, dark purplish-red ecchymoses appearing on the dorsa of the forearms and less often the hands. An aquaporin-inspired lipid concentrate for mature skin. This product contains retinol, ?-hydroxy acids, arnica oil, ceramides, niacinamide, and phytonadione, which effectively treat actinic purpura by improving local circulation, thickening the skin, and repairing the skin barrier. Some people develop areas of spots 2 mm or even smaller. This treatment is normally only effective in the short term. One case report describes this extreme procedure in which affected skin is excised first before placement of the graft. Learn about causes of bleeding into the skin, bruising, diagnosis, and. Book: Textbook of Dermatology. 6. Attempts to increase the dermal thickness have been tried with topical retinoids and AHAs with minimum benefits. Guidelines for patient management. Results showed that this treatment has the potential to be an effective antiaging treatment in the future. A survey of skin problems and skin care regimens in the elderly. We prefer the term sunburn purpura because it reflects the acuity of the phenomenon, as opposed to the previous labels solar purpura or photolocalized purpura, which also could suggest causality from chronic sun exposure.It has been proposed that sunburn purpura is a . Aging Clin Exp Res. J Am Acad Dermatol. Thrombocytopenia, which is a deficiency in blood platelets, can cause bleeding and bruising in the dermis similar to senile purpura. Last medically reviewed on December 19, 2022, Anemia rash is a term that refers to red pinpricks that appear on the skin and are caused by a low platelet count. This leaves them more at risk of the bleeding that creates purpuras typical rash. Arch Dermatol. The initial signs of senile purpura are purple or red bruises that have an irregular shape. Other names for this include solar purpura, senile purpura, traumatic purpura, and Bateman's disease. Actinic purpura seen on the forearm of an elderly female. J Dermatolog Treat. There may also be an increased incidence in people who take aspirin, anticoagulants, or nonsteroidal anti-inflammatory medications (NSAIDs). However, a person can speak with their doctor or dermatologist about options for reducing or improving the appearance of these marks. Background: Senile purpura is a common, chronic skin condition affecting more than 10 percent of individuals over the age of 50. The theory is to thicken the dermis and improve the overall appearance of the skin. 2010. pp. 2008;20:195200. Purpura is the name given to the discolouration of the skin or mucous membranes due to haemorrhage from small blood vessels. Learn, Minor bleeding into the skin is common and often the result of an injury. Numerous studies have demonstrated the beneficial effects of topical retinol, a precursor of retinoic acid. After the bruise is gone, discoloration may remain at the site for a long time. Senile purpura Senile purpura Senile purpura Senile purpura Who is at risk of senile purpura? arrow-right-small-blue Topical vitamin K1 promotes repair of full thickness wound in rat. Actinic purpura is characterized by ecchymoses on the extensor surfaces of the forearms and the dorsa of the hands that usually last 1-3 weeks. Poljak B, Dahmane RG, Godi? 2005;76:135141. Arch Facial Plast Surg. The initial signs of senile purpura are purple or red bruises that have an irregular shape. 7. Results showed that fasting plasma zinc levels were lower in those with senile purpura, than those without. RM A4GRJA - Arthritis resulting from a pyogenic infection of the joint cavity. Shavit Gavish May 6, 2018 Skin, Hair and Nails No Comments. Herbal remedies such as arnica and bromelain- more studies are needed to fully assess the efficacy in reducing the severity of bruising when using these treatments. 28. Henoch-Schonlein purpura (HSP) is a disease that involves inflammation which causes blood vessels in the skin, intestines, kidneys, and joints to start leaking. No treatment is necessary for this type of purpura. Bateman's purpura is a result of changes to the skin as a result of chronic sun exposure. It was first described by Dr. Bateman in 1818. When purpura results from a blood clotting condition, the untreated disorder can cause life threatening bleeding. For more information, call The S.F. Actinic purpura occurs almost exclusively among the elderly population, although it may occasionally occur in younger people. Actinic purpura is characterized by dark purple patches and macules on the sun-exposed areas such as hands, face, forearm, neck, and legs affecting older people. [47] Facial images and instrumental measures were obtained at baseline and at four-week intervals. Secondary thrombocytopaenic purpura due to external or internal factors such as drugs, Deficient vascular support, as in aged or sun damaged skin (. Skin disorders in elderly subjects. Histopathology consists of features of aging skin including flattening of the dermal-epidermal junction, decreased elastic fibers, fibroblasts and collagen, as well as thinning of dermal vasculature. Treatment for Henoch-Schnlein purpura focuses on improving the symptoms. Niacinamide. Dermatologists call it 'actinic purpura', 'solar purpura' or 'Bateman's purpura'. Medication that causes dry skin Arch Dermatol. Most of the customer testimonies that concern actinic keratosis and skin lesions involve the Perrin's Blend. Actinic purpura is caused by skin aging, both intrinsic and solar, and can occur with or without skin trauma. Treatment is usually unnecessary and complications are rarely reported. 2015;14:271280. Moisturizing effects of topical nicotinamide on atopic dry skin. Doctors may prescribe drugs to suppress the immune system if kidney damage is severe. "Actinic prurigo and polymorphic light eruption: common pathogenesis and the importance of HLA-DR4/DRB1*0407". As my daughter commented when I told her that, "how rude!". In some cases, doctors may recommend NSAIDs to reduce inflammation and pain. 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. Medicine, science concept. 1989;43:222228. Bissett DL, Oblong JE, Berge CA. 33. 37. Treatments vary depending on a persons specific needs, so all medications and treatments should be discussed with a doctor. For example, they may appear brownish-black on darker complexions and reddish-purple on lighter complexions. Resurfacing with topical agents. Reszke R, Pe?ka D, Walasek A, et al. [50] There was no difference in the extent of bruising on the topical vitamin K-treated sides; however, the severity of bruising was significantly less on the vitamin K-treated sides. Actinic purpura, also known as Bateman's or senile purpura, is due to the rupture of delicate blood vessel walls, leading to an erythematous purpura most often seen on the dorsum of the hands in elderly populations . Dermatol Surg. Draelos ZD, Ertel K, Berge C. Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea. While we often refer to this as a condition caused by aging, it's more accurately a condition caused by years of sun damage. These rashes often appear on the, Purpura and petechiae are discolored spots of skin that result from leaking blood vessels. Taking these types of medications increase the risk of internal bleeding, but having this skin condition doesn't mean you have an especially high bleeding risk. It mostly occurs in elderly people, and the effects are more pronounced in fair-skinned individuals. 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.20 Similarly, the topical application of 0.1% retinol in another study increased keratinocyte proliferation and epidermal thickness and improved major signs of skin aging. The clinical anti-aging effects of topical kinetin and niacinamide in Asians: a randomized, double-blind, placebo-controlled, split-face comparative trial. The rash can resemble tiny clusters of bruises. However, the risk of retinoid dermatitis may outweigh the benefits. Actinic changes Senile Purpura Images Picture 1 : Senile Purpura on lower legs Image source : patient.co.uk Picture 2 : Senile Purpura Photo Image source : patient.co.uk Diagnosis Laboratory tests Normal platelet count Positive capillary fragility test Normal hemostasis Diagnostic criteria Contact Dermatitis. ), Holzer, G, Riegler, E, Honigsmann, H. Effects and side-effects of 2% progesterone cream on the skin of peri- and post menopausal women: results from a double-blind, vehicle-controlled, randomized study. 1994;86:645648. 2002;46:331338. Steroid purpura Their classification depends on the appearance or cause of the condition. Patients with ITP experience platelet destruction in the bloodstream. 2014;79:256264. The only effective method for preventing purpura is avoiding the conditions that cause it. They appear as small, reddish-purple spots just beneath the skins surface. People who are uncomfortable with the appearance of senile purpura may contact a dermatologist for recommendations to heal and replenish the damaged skin. Underlying causes, such as leukemia, need to be treated, as do effects such as kidney failure. Small lesions (< 2 mm) are termed petechiae, and large lesions are termed ecchymoses or bruises. Chen AC, Martin AJ, Choy B, et al. MEDICAL THERAPIES (the goal is to prevent further skin aging). Finding the underlying cause of purpura can be tricky. If a doctor suspects Henoch-Schnlein purpura, urine tests can assess kidney function by testing for protein and blood in the urine. 18. Purpuras can also be a side effect of some cancers, including lymphoma and leukemia. J Cosmet Dermatol. 32. 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. The primary symptom of Senile purpura is large, purple-red bruises that are most common on the . J Am Acad Dermatol. Enjoying our content? 2001;17:617630. Both romiplostim (Nplate) and eltrombopag (Promacta) encourage the bone marrow to produce more platelets. [34],[35] As a result of skin barrier defects, up to 75 percent of elderly patients are affected by xerosis. Similar to other skin conditions, the incidence of actinic purpura increases with advancing age and occurs with equal frequency among men and women. 232-6. The prevalence is as high as 10 to 12% in patients aged 70-90 year; it is more common in women 5 6. Kligman AM. A range of underlying medical conditions can cause both kinds of purpura. I get purple spots on my forearms that are called actinic purpura, or very insultingly, senile purpura. (Placebo-controlled, randomized, prospective study in 75 postmenopausal women who applied topical DHEA cream (ranging from 0.1-2%) twice daily to several areas on the body for 13 weeks. Another suggests actinic purpura affects less than 10 percent of people over 50 years old. In general, results showed that patients taking arnica had less ecchymosis than placebo. Not all cases of purpura demand immediate treatment. 17. Blanchability is the clinical sign that best distinguishes the two. Lifestyle treatments can also help since drugs such as aspirin prevent platelets from aggregating and clotting. "Actinic" and "solar" both mean sun. SIZE Dimensions vary from a tiny spot to as much as an inch in diameter. 2012;22:3641. Sahle FF, Gebre-Mariam T, Dobner B, et al. 1995;131:493495. The most common variant of progressive pigmentary dermatosis is Schamberg disease. This cut can be treated in the same way as a regular cut. alpha-Hydroxy acid-based cosmetic procedures. If the doctor suspects ITP, they may order additional testing. . Zinc deficiency in senile purpura. Henoch-Schnlein purpura may also cause a rare condition in which the bowel folds over itself; this creates a bowel obstruction that restricts digestion. The effect of an emollient containing urea, ceramide NP, and lactate on skin barrier structure and function in older people with dry skin. RF 2B19X53 - Dry skin with wrinkles on the hands of an elderly . I am including pictures of my purpura so you can see if this what you also have. Chiu PC, Chan CC, Lin HM, et al. Only the lesions erupted on the skin may be emotionally distressful and irritating to the patients because it creates a cosmetic disfigurement of the skin. Actinic purpura does not require any specific treatment. This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. Senile purpura (also known as "Actinic purpura," and "Solar purpura") was first described by Bateman 1 in 1818 when he noted dark purple blotches and determined that they were due to the extravasation of blood into the dermal tissue. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. Meckfessel MH, Brandt S. The structure, function, and importance of ceramides in skin and their use as therapeutic agents in skin-care products. Similar to other skin conditions, the incidence of actinic purpura increases with advancing age and occurs with equal frequency among men and women. 39. Take our 'Different Causes of Purpura Quiz' for health professionals. This medication can also help manage purpura in people who are resistant to corticosteroid therapies. 163. Solar purpura can also sometimes develop . - Conference Coverage Can diet help improve depression symptoms? Purpura that is not associated with lower platelet levels (nonthrombocytopenic purpura) has a range of causes and risk factors, including: Purpura with a lowered platelet count (thrombocytopenia) has several potential causes: ITP occurs when the body attacks its platelets, increasing the risk of bleeding and purpuric rashes. MEDICAL PROFESSIONAL. Immune thrombocytopenic purpura (ITP), also known as idiopathic thrombocytopenic purpura or immune thrombocytopenia, is a type of thrombocytopenic purpura defined as an isolated low platelet count with a normal bone marrow in the absence of other causes of low platelets. Purpura is a physical sign of an underlying disease, rather than a disease in itself, with many potential causes. Symptoms are usually resolved within three weeks. Al-Nuaimi Y, Sherratt MJ, Griffiths CE. (Geriatric study of prognostic factors of senile purpura (SP) in 1125 elderly Chinese patients. PEW Research Center, February 3, 2014. http://www.pewresearch.org/fact-tank/2014/02/03/10-projections-for-the-global-population-in-2050/.