eMedicine Specialties > Dermatology > Diseases of the Vessels

Actinic Purpura: Follow-up

Author: Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Coauthor(s): Vinay Arya, MD, Staff Physician, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine; George Kihiczak, MD, Clinical Associate Professor, Department of Dermatology, New Jersey Medical School and University Hospital
Contributor Information and Disclosures

Updated: May 12, 2008

Follow-up

Inpatient & Outpatient Medications

  • Recommend the use of sunscreens that provide both UV-A and UV-B protection.

Deterrence/Prevention

  • Actinic purpura can be prevented by using lifelong sun protection.
  • Advise patients to adhere to the following precautions, starting at the earliest possible age.

    • Avoid sun exposure when the most damaging rays are present (ie, from 10 am to 3 pm).
    • Wear clothing at all times while outdoors to serve as barrier protection from the sun's UV rays.
    • Apply sunscreens that protect against UV-A and UV-B radiation daily, especially to areas of the skin that are not covered by barrier protection.

Complications

  • Actinic purpura is a benign condition and does not have serious complications.
  • The lesions may be emotionally distressing to patients because of the cosmetic disfigurement of the skin.

Prognosis

  • Individual lesions of actinic purpura generally resolve within 1-3 weeks.
  • Residual hemosiderosis may occur. Purpuric lesions usually continue to occur during the individual's life.

Patient Education

  • Reassure the patient that this condition is benign.
  • Emphasize the absolute necessity of using sunscreen and barrier protection to prevent further photodamage.
  • Inform patients that sunscreens do not reverse photodamage.
  • Instruct patients to minimize any trauma to the skin where the purpuric lesions are present.

Miscellaneous

Medicolegal Pitfalls

  • The clinical sign of purpura is not necessarily benign.
    • Although actinic purpura does not have serious sequelae, other causes of purpura can be serious.
    • An incorrect diagnosis as to the etiology of purpuric lesions can be medically and legally disastrous.
 


More on Actinic Purpura

Overview: Actinic Purpura
Differential Diagnoses & Workup: Actinic Purpura
Treatment & Medication: Actinic Purpura
Follow-up: Actinic Purpura
References
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References

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Further Reading

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Keywords

Bateman actinic purpura, solar purpura, senile purpura, ultraviolet radiation–induced skin changes, chronic sun exposure

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Contributor Information and Disclosures

Author

Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Coauthor(s)

Vinay Arya, MD, Staff Physician, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine
Vinay Arya, MD is a member of the following medical societies: Sigma Xi
Disclosure: Nothing to disclose.

George Kihiczak, MD, Clinical Associate Professor, Department of Dermatology, New Jersey Medical School and University Hospital
George Kihiczak, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, and Medical Society of New Jersey
Disclosure: Nothing to disclose.

Medical Editor

Julie R Kenner, MD, PhD, Consultant, Clinical Research, Medical Affairs, VaxGen, Inc; Private Practice, Kenner Dermatology Center
Julie R Kenner, MD, PhD is a member of the following medical societies: American Academy of Dermatology and American Society of Tropical Medicine and Hygiene
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Director, Division of Dermatology, Scott and White Clinic; Director Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: 3M Pharmaceutical Grant/research funds Other; Graceway Pharmaceuticals Grant/research funds Other

Managing Editor

Jeffrey J Miller, MD, Associate Professor, Department of Dermatology, Penn State University, Milton S Hershey Medical Center
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

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