PMC3617970_01
Clinicopathological findings of Case 1. a Stage IV pressure ulcer with skin pocket was noted in the patient's sacral area. b Skin atrophy, senile purpura, stellate pseudoscars, and skin lacerations were observed on the forearms. c Histopathology revealed epidermal thinning and dermal solar elastosis (Hematoxylin and eosin, x100). d Azan staining demonstrated the degeneration of dermal collagen fibers, here stained blue (x400). e Elastica van Gieson staining demonstrated the degeneration of elastic fibers, here stained black (x400). f In spite of treatment including skin incision, the sacral pressure ulcer had still not healed completely 6 months afterwards.
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F1
This lesion measured 3 x 4 cm and included a large undermining skin pocket (fig. 1a). In addition, senile purpura, stellate pseudoscars, and skin lacerations were observed on the forearms (fig. 1b). Histopathology of the left forearm revealed epidermal thinning with loss of the normal rete ridge pattern and dermal solar elastosis (fig. 1c). Azan and Elastica van Gieson staining demonstrated the degeneration of the dermal collagen fibers and elastic fibers, respectively (fig. 1d, e). After 6 months of treatment, the patient was transferred to an extended care hospital, although even at this point the wound had not healed sufficiently (fig. 1f).
PMC3617970_02
Clinical appearance of Case 2. a Stage II pressure ulcer developed on the sacral area. b Skin atrophy, senile purpura, stellate pseudoscars, and skin lacerations, were noted on the forearms.
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F2
A 74-year-old male who had been admitted to the coronary care unit of our hospital due to serious heart failure developed a stage II sacral pressure ulcer that measured 1.5 x 3 cm (fig. 2a). On the forearms were clinical signs of stage II primary dermatoporosis, including skin atrophy, senile purpura, stellate pseudoscars, and skin lacerations (fig. 2b).
PMC3617970_03
Clinical appearance of Case 3. a Stage II pressure ulcer developed in the sacral area. b Skin atrophy, senile purpura, and stellate pseudoscars were again noted on the forearms.
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F3
A 97-year-old female with gait disorder visited our outpatient clinic for treatment of a stage II sacral pressure ulcer that measured 2 x 2.5 cm (fig. 3a). On her forearms were clinical signs of stage I primary dermatoporosis, such as skin atrophy, senile purpura, and stellate pseudoscars (fig. 3b).