Clinical Application Questions

A 65-year-old active sailor presents with a history of progressive bruising of the arms over the past 3 to 4 years. Bruises now occur with such frequency and following such minor trauma that his wife is concerned about some underlying medical problem. Exam reveals large bruises limited to the sun-exposed extensor surfaces of the arms, forearms, and hands. The history and physical findings suggest senile (Bateman's) purpura.

1. What additional history will support your diagnosis?

2. What are the primary lesions of senile purpura?

3. What are the secondary lesions of senile purpura?

4. What is the typical configuration of senile purpura?

5. What is the characteristic distribution of senile purpura?

6. What is the most important treatment for this problem?

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