A 78-year-old patient recently noticed dark blotches on his forearms and on the backs of his hands. He seems to bruise even when a phlebotomy is performed using excellent technique with no problems encountered
No other symptoms exist, and all laboratory tests are normal. Which of the following is the most likely diagnosis?
a. Hereditary hemorrhagic telangiectasia
b. Ehlers-Danlos syndrome
c. Paraproteinemia and amyloidosis
d. Senile purpura
ANS: D
Senile purpura is the most likely diagnosis for this 78-year-old man who only recently began to notice abnormal bruising and/or bleeding. The hereditary abnormalities would have presented earlier in life. Paraproteinemia and amyloidosis would demonstrate other abnormal clinical laboratory testing.
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