Case Report
BibTex RIS Cite

Actinic Purpura in a Patient in the Intensive Care Unit: Case Report

Year 2018, Volume: 2 Issue: 2, 13 - 16, 19.12.2018

Berna Aksoy , Aslı Tatlıparmak Erol Koç Gonca Gökdemir A. Nimet Karadayı

Abstract

Actinic purpura is a dermatological
disorder that is seen frequently in elderly as benign ecchymotic plaques with
various sizes and localizations. A 92-year-old woman was consulted for purple
lesions in the body while she was being treated in intensive care unit (ICU).
The lesions were intermittent and improved spontaneously for three years. She
had left-sided hemiplegia sequel, asthma and newly developed right sided
hemiplegia. Dermatological examination revealed ecchymotic plaques with 3-10 cm
diameter in forehead, eyelids, neck, chest and distal upper extremities.
Histopathological examination of a lesional biopsy revealed epidermal atrophy,
widespread solar elastosis in the dermis and focal hemorrhagic areas. The
impairment of general condition of the patient continued and the patient lost
his life as a result of complications at the 12th day of ICU. Widespread
actinic purpura that is misdiagnosed as physical assault can be seen
infrequently at the admission to ICU. The presence of actinic purpura is
accepted as a poor prognostic sign in the hospitalized patients.  

Keywords

actinic purpura senile

References

  • 1. Reszke R, Pełka D, Walasek A, Machaj Z, Reich A. Skin disorders in elderly subjects. Int J Dermatol 2015;54:e332-8.
  • 2. Borroni RG, Grassi S, Concardi M, Agozzino M, Caspani C, Giordano C, et al. Involvement of dermal microvascular basement membrane in senile purpura: quantitative immunohistochemical study. J Eur Acad Dermatol Venereol 2016;30:e63-e65.
  • 3. Murad AA, Jeffers M, Tobin AM, Connolly M. Purpura fulminans in a patient with mixed connective tissue disease. BMJ Case Rep 2013;2013:bcr2012007947.
  • 4. Zou X, Wu T, Zhang X, Qu A, Tian S. Thrombotic thrombocytopenic purpura (TPP) successfully rescued by plasma exchange in the ICU: A report of two cases. Exp Ther Med 2016;12:329-332.
  • 5. Adya KA, Inamadar AC, Palit A. Anticoagulants in dermatology. Indian J Dermatol Venereol Leprol 2016;82:626-640.
  • 6. Wong HY. Hypothesis: Senile purpura is a prognostic feature in elderly patients. Age and Aging 1988;17:422-424.

ACTINIC PURPURA IN A PATIENT IN THE INTENSIVE CARE UNIT: CASE REPORT

Year 2018, Volume: 2 Issue: 2, 13 - 16, 19.12.2018

Berna Aksoy , Aslı Tatlıparmak Erol Koç Gonca Gökdemir A. Nimet Karadayı

Abstract

Aktinik purpura çeşitli büyüklük ve lokalizasyonlarda benign ekimotik plaklar olarak yaşlılarda sık olarak görülen dermatolojik bir hastalıktır. 92 yaşındaki bir kadın yoğun bakım ünitesinde yatarken vücudundaki mor lezyonları nedeniyle konsülte edildi. Lezyonlar üç yıldır aralıklı olarak tekrar ediyor ve kendiliğinden iyileşiyordu. Hastanın sol hemiplji sekerli, astımı ve yeni gelişen sağ hemiplejisi vardı. Dermatolojik muayenede alın, göz kapakları, boyun, göğüs ve distal üst ekstremitelerde 3-10 cm çaplarında ekimotik plaklar mevcuttu. Bir lezyondan alınanbiyopsinin histopatolojik incelemesi epidermal atrodi, dermişte yaygın solar elastoz ve fokal hemoraji alanlarını gösterdi. Hastanın genel durumundaki bozukluk devam etti ve yoğun bakım ünitesindeki 12. gününde hayatını kaybetti. Fiziksel travma olarak yanlış tanı alabilen yaygın aktinik purpura yoğun bakım ünitelerinden sıkça görülebilir. Aktinik purpuranın mevcudiyeti hospitalize hastalarda kötü prognostik belirti olarak kabul edilir.

Keywords

Aktinik purpura senil yoğun bakım ünitesi

References

  • 1. Reszke R, Pełka D, Walasek A, Machaj Z, Reich A. Skin disorders in elderly subjects. Int J Dermatol 2015;54:e332-8.
  • 2. Borroni RG, Grassi S, Concardi M, Agozzino M, Caspani C, Giordano C, et al. Involvement of dermal microvascular basement membrane in senile purpura: quantitative immunohistochemical study. J Eur Acad Dermatol Venereol 2016;30:e63-e65.
  • 3. Murad AA, Jeffers M, Tobin AM, Connolly M. Purpura fulminans in a patient with mixed connective tissue disease. BMJ Case Rep 2013;2013:bcr2012007947.
  • 4. Zou X, Wu T, Zhang X, Qu A, Tian S. Thrombotic thrombocytopenic purpura (TPP) successfully rescued by plasma exchange in the ICU: A report of two cases. Exp Ther Med 2016;12:329-332.
  • 5. Adya KA, Inamadar AC, Palit A. Anticoagulants in dermatology. Indian J Dermatol Venereol Leprol 2016;82:626-640.
  • 6. Wong HY. Hypothesis: Senile purpura is a prognostic feature in elderly patients. Age and Aging 1988;17:422-424.
There are 6 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Case Reports
Authors

Berna Aksoy 0000-0003-2346-1865

Aslı Tatlıparmak This is me 0000-0001-9177-2273

Erol Koç This is me 0000-0003-4147-2015

Gonca Gökdemir This is me 0000-0002-6298-7715

A. Nimet Karadayı This is me 0000-0001-8659-2155

Publication Date December 19, 2018
Published in Issue Year 2018 Volume: 2 Issue: 2

Cite

APA Aksoy, B., Tatlıparmak, A., Koç, E., Gökdemir, G., et al. (2018). Actinic Purpura in a Patient in the Intensive Care Unit: Case Report. DOD Clinical Case Reports, 2(2), 13-16.
AMA Aksoy B, Tatlıparmak A, Koç E, Gökdemir G, Karadayı AN. Actinic Purpura in a Patient in the Intensive Care Unit: Case Report. DODCR. December 2018;2(2):13-16.
Chicago Aksoy, Berna, Aslı Tatlıparmak, Erol Koç, Gonca Gökdemir, and A. Nimet Karadayı. “Actinic Purpura in a Patient in the Intensive Care Unit: Case Report”. DOD Clinical Case Reports 2, no. 2 (December 2018): 13-16.
EndNote Aksoy B, Tatlıparmak A, Koç E, Gökdemir G, Karadayı AN (December 1, 2018) Actinic Purpura in a Patient in the Intensive Care Unit: Case Report. DOD Clinical Case Reports 2 2 13–16.
IEEE B. Aksoy, A. Tatlıparmak, E. Koç, G. Gökdemir, and A. N. Karadayı, “Actinic Purpura in a Patient in the Intensive Care Unit: Case Report”, DODCR, vol. 2, no. 2, pp. 13–16, 2018.
ISNAD Aksoy, Berna et al. “Actinic Purpura in a Patient in the Intensive Care Unit: Case Report”. DOD Clinical Case Reports 2/2 (December 2018), 13-16.
JAMA Aksoy B, Tatlıparmak A, Koç E, Gökdemir G, Karadayı AN. Actinic Purpura in a Patient in the Intensive Care Unit: Case Report. DODCR. 2018;2:13–16.
MLA Aksoy, Berna et al. “Actinic Purpura in a Patient in the Intensive Care Unit: Case Report”. DOD Clinical Case Reports, vol. 2, no. 2, 2018, pp. 13-16.
Vancouver Aksoy B, Tatlıparmak A, Koç E, Gökdemir G, Karadayı AN. Actinic Purpura in a Patient in the Intensive Care Unit: Case Report. DODCR. 2018;2(2):13-6.