PURPURA
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Does anyone have rx ideas for a gentleman in his 50's with terrible
traumatic purpura bilateral arms. He is on Prednisone for a questionable
diagnosis of late onset asthma, has a cardiomyopathy, and I was expecting
amyloid on the biopsy-but it was just purpura in actinically damaged skin.
He was a big heliolater.  He has used topical Retin A to beef up the
structural support for over one year.

Diane Thaler
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For easy bruisability--I think I read somewhere that Alphahydroxy acid creams
might help.

William.Liss
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There were some reports of Vit K cream for bruising and purpura but my
limited experience w/ them has not been rewarding.

Jeff Marmelzat, M.D.
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LacHydrin tid works better for me than retinA for photo/steroid purpura.

Guy Webster
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I'd try Dilantin 100 mgm daily for the solar ecchymoses:  it's ability to 
enhance fibroblast 
activity is well known, and I've had some nice results.  I'd also add Vit C 2 
gm daily.

Robert I. Rudolph, M.D., FACP
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I will start him on Aqua Glycolic Lotion. Does anyone else have favorite 
preparations? 

Diane Thaler
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LacHydrin or 10% Glycolic. Helps a little, and is much less
expensive.  If pt is still on too high a steroid dose the results are not
good with anything.  Topical Vitamin C also too many $$$$.  Is anyone still
using oral vitamins, zinc, etc?

Gene Sienkiewicz, M. D.
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 I used to love Lachydrin and then two things happened. My very mellow
husband expressed a dislike of the fragrance/or lack of masking and a
patient with quaternium 15 sensitivity was given a bottle of it by the
allergist she works for.  I think quaternium l5 is still in it. It is a big
sensitizer here. As absurd as it is, I had never thought of using a
therapeutic moisturizer TID!. 

Diane Thaler
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