Therapeutic options in dermatoporosis: A case report

Authors

  • Windy Keumala Budianti Department of Dermatology and Venereology, Universitas Indonesia, Jakarta, Indonesia
  • Leny Purnamasari Department of Dermatology and Venereology, Universitas Indonesia, Jakarta, Indonesia

Keywords:

dermatoporosis, senile purpura, skin aging, moisturizers, therapy

Abstract

Dermatoporosis is a chronic skin insufficiency syndrome with typical manifestations of extreme skin atrophy, senile purpura, stellate pseudoscars, skin lacerations, and skin dissecting hematomas at the age of 70–90 years old. It is caused by aging process, and triggered by environmental factors and drugs which lead to the skin's protective mechanical function loss. The prevalence was 32% in French Hospitals and 30.7% in the Central Hospital of the University of Helsinki, Finland. We report a dermatoporosis case to raise awareness in clinical practice and trace study literature for choosing the most appropriate therapy. An 89-year-old man complained of red and itchy patches on his skin since the last six months. Physical examination shows dry skin, atrophy, purpura, stellate pseudoscars, and multiple arms and lower leg lacerations. The patient had been given ceramide moisturizer, but there is no significant improvement. Structural and functional skin damage in elderly is not just cosmetic problem. However, it significantly impacts life quality and increases morbidity and mortality risk if it develops into a serious condition. Therefore, clinicians have an essential role in proper management to prevent complications. Several studies have shown that hyaluronic acid and retinaldehyde improve skin function in dermatoporosis.

References

Kaya G, Kaya A, Sorg O, Saurat JH. Dermatoporosis, a Prevalent Skin Condition Affecting The Elderly: Current Situation and Potential Treatments. Clin Dermatol. 2019;37(4):346–50.

Yusharyahya SN. Mekanisme Penuaan Kulit sebagai Dasar Pencegahan dan Pengobatan Kulit Menua. eJournal Kedokteran Indonesia. 2021;9(2):150.

Re Domínguez ML, Di Martino Ortiz B, Rodríguez Masi M, Knopfelmacher Domínguez O, Bolla Argüello de Lezcano L. Dermatoporosis, An Emerging Disease. Case Report. Our Dermatol Online. 2016;7(2):191–4.

Kaya G, Kaya A, Sorg O, Saurat JH. Dermatoporosis: a further step to recognition. Vol. 32, Journal of the European Academy of Dermatology and Venereology. Blackwell Publishing Ltd; 2018. p. 189–91.

Mengeaud V, Dautezac-Vieu C, Josse G, Vellas B, Schmitt AM. Prevalence of Dermatoporosis in Elderly French Hospital in-patients: A Cross-Sectional Study. Br J Dermatol. 2012;166(2):442–3.

Saurat JH, Mengeaud V, Georgescu V, Coutanceau C, Ezzedine K, Taïeb C. A Simple Self-Diagnosis Tool to Assess The Prevalence of Dermatoporosis in France. J Eur Acad Dermatol Venereol. 2017;31(8):1380–6.

Dyer JM, Miller RA. Chronic Skin Fragility of Aging: Current Concepts in the Pathogenesis, Recognition, and Management of Dermatoporosis. J Clin Aesthet Dermatol. 2018;11(1):13–8.

Nikolic DS, Ziori C, Kostaki M, Fontao L, Saurat JH, Kaya G. Hyalurosome Gene Regulation and Dose-Dependent Restoration of Skin Atrophy by Retinaldehyde and Defined-Size Hyaluronate Fragments in Dermatoporosis. Dermatology. 2014; 229(2):110–5.

Koyano Y, Nakagami G, Iizaka S, Sugama J, Sanada H. Skin Property can Predict the Development of Skin Tears Among Elderly Patients: A Prospective Cohort Study. Int Wound J. 2017;14(4):691–7.

Meckfessel MH, Brandt S. The Structure, Function, and Importance of Ceramides in Skin and Their Use as Therapeutic Agents in Skin-care Products. J Am Acad Dermatol. 2014;71(1):177–84.

Lodén M, Maibach HI. Treatment of Dry Skin Syndrome: The Art and Science of Moisturizers. Treatment of Dry Skin Syndrome: The Art and Science of Moisturizers. 2012;9783642276:1–591.

Humbert P, Fanian F, Lihoreau T, Jeudy A, Pierard GE. Bateman purpura (dermatoporosis): a localized scurvy treated by topical vitamin C – double-blind randomized placebo-controlled clinical trial. J Eur Acad Dermatol Venereol. 2018;32(2):323–8.

Berlin JM, Eisenberg DP, Berlin MB, Sarro RA, Leeman DR, Fein H. A randomized, placebo-controlled, double-blind study to evaluate the efficacy of a citrus bioflavanoid blend in the treatment of senile purpura. J Drugs Dermatol. 2011;10(7):718–22.

Kaya G, Kaya A, Saurat JH. Induction of Hyalurosome by Topical Hyaluronate Fragments: Results in Superficial Filling of the Skin Complementary to Hyaluronate Filler Injections. Dermatopathology. 2019;6(2):45–9.

Nur Islami N, Rizky M, Adipurna Syamsunarno A, Sahiratmadja E, Islami NN. The Role of Hyaluronic Acid in Skin Treatment during COVID-19 Pandemic. Systematic Reviews in Pharmacy. 2020 Vol. 11.

Cordero A, Leon-Dorantes G, Pons-Guiraud A, Di Pietro A, Vidal Asensi S, Walkiewicz-Cyraska B, et al. Retinaldehyde⁄hyaluronic acid fragments: a synergistic association for the management of skin aging. J Cosmet Dermatol. 2011;10(2):110-7.

McKnight B, Seidel R, Moy R. Topical Human Epidermal Growth Factor in the Treatment of Senile Purpura and the Prevention of Dermatoporosis. J Drugs Dermatol. 2015;14(10):1147–50.

Siperstein R, Wikramanayake TC. Intense Pulsed Light as a Treatment for Senile Purpura: A Pilot Study. Lasers Surg Med. 2021;53(7):926–34.

Baek G, Kim MH, Jue MS. Efficacy of microneedle radiofrequency therapy in the treatment of senile purpura: A prospective study. Skin Res Tech. 2022;28(6):856–64.

Baulieu EE, Thomas G, Legrain S, Lahlou N, Roger M, Debuire B, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci. 2000;97(8):4279–84.

Maheux R, Naud F, Rioux M, Grenier R, Lemay A, Guy J, et al. A randomized, double-blind, placebo-controlled study on the effect of conjugated estrogens on skin thickness. Am J Obstet Gynecol. 1994;170(2):642–9.

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Published

2024-04-21

How to Cite

1.
Budianti WK, Purnamasari L. Therapeutic options in dermatoporosis: A case report. J Pak Assoc Dermatol [Internet]. 2024Apr.21 [cited 2024May22];34(2):577-81. Available from: https://jpad.com.pk/index.php/jpad/article/view/2470

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Case Reports