Skip to main content

Advertisement

SpringerLink
Log in

Skin Disease and Neurological Conditions of the Elderly

  • Dermatology and Wound Care (C Sayed and D Culton, Section Editors)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Summarize and review the body of literature associating neurological diseases of the elderly with cutaneous disease.

Recent Findings

A growing body of evidence supports a close association between Parkinson’s disease and seborrheic dermatitis or rosacea, as well as a higher risk of melanoma. Development of bullous pemphigoid has also been found to be at higher incidence in those with multiple sclerosis. In some cases, skin disease may suggest early diagnosis of a developing neurologic condition, while in others, presence of a neurologic condition should prompt careful evaluation for cutaneous disease.

Summary

Elderly patients with neurodegenerative conditions should prompt evaluation for both benign facial dermatologic disease and bullous disease. Further research might elicit antigenic cross-reactivity between CNS epitopes and those in the skin.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Hurko O, Provost TT. Neurology and the skin. J Neurol Neurosurg Psychiatry. 1999;66:417–30.

    Article  CAS  Google Scholar 

  2. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2917–223.

    Google Scholar 

  3. Van Den Eeden SK, Tanner CM, Bernstein AL, Fross RD, Leimpeter A, Bloch DA, et al. Incidence of Parkinson’s disease: variation by age, gender, and race/ethnicity. Am J Epidemiol. 2003;157:1015–22.

    Article  Google Scholar 

  4. Galvan A, Wichmann T. Pathophysiology of Parkinsonism. Clin Neurophysiol. 2008;119(7):1459–74.

    Article  CAS  Google Scholar 

  5. Ravn A-H, Thyssen JP, Egeberg A. Skin disorders in Parkinson’s disease: potential biomarkers and risk factors. Clin Cosmet Investig Dermatol. 2017;10:87–92.

    Article  CAS  Google Scholar 

  6. de Lau LM, Breteler MM. Epidemiology of Parkinson’s disease. Lancet Neurol. 2006;5:525–35.

    Article  Google Scholar 

  7. Chaudhuri KR, Schapira AH. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol. 2009;8:464–74.

    Article  CAS  Google Scholar 

  8. Gregory R, Miller S. Parkinson’s disease and the skin. Pract Neurol. 2015;15:246–9.

    Article  Google Scholar 

  9. Gupta AK, Madzia SE, Batra R. Etiology and management of seborrheic dermatitis. Dermatology. 2004;208:89–93.

    Article  Google Scholar 

  10. Arsic Arsenijevic VS, Milobratovic D, Barac AM, Vekic B, Marinkovic J, Kostic VS. A laboratory-based study on patients with Parkinson’s disease and seborrheic dermatitis: the presence and density of Malassezia yeasts, their different species and enzymes production. BMC Dermatol. 2014;14:5.

    Article  Google Scholar 

  11. Braak H, Del Tredici K. Non-dopaminergic pathology of Parkinson’s disease. In: Olanow CW, Stocchi F, Lang AE, editors. Parkinson’s disease; 2011.

    Google Scholar 

  12. • Tanner C, Albers K, Goldman S, Fross R, Leimpeter A, Klingman J, et al. Seborrheic dermatitis and risk of future Parkinson’s disease (PD)(S42. 001). Neurology. 2012;78(1 Supplement):S42–001 Retrospective review study which demonstrates that diagnosis of seborrheic dermatitis can precede and signal eventual diagnosis of Parkinson’s disease.

    Google Scholar 

  13. Burton JL, Cartlidge M, Cartlidge NEF, Shuster S. Sebum excretion in Parkinsonism. Br J Dermatol. 1973;88:263–6.

    Article  CAS  Google Scholar 

  14. Burton JL, Shuster S. Effect of L-Dopa on seborrhœa of Parkinsonism. Lancet. 1970;2(7662):19–20.

    Article  CAS  Google Scholar 

  15. Cowley NC, Farr RM, Shuster S. The permissive effect of sebum in seborrhoeic dermatitis: an explanation of the rash in neurological disorders. Br J Dermatol. 1990;122:71–6.

    Article  CAS  Google Scholar 

  16. Culp B, Scheinfeld N. Rosacea: a review. P T. 2009;34(1):38–45.

    PubMed  PubMed Central  Google Scholar 

  17. Steinhoff M, Buddenkotte J, Aubert J, et al. Clinical, cellular, and molecular aspects in the pathophysiology of rosacea. J Investig Dermatol Symp Proc. 2011;15:2–11.

    Article  CAS  Google Scholar 

  18. Egeberg A, Hansen PR, Gislason GH, Thyssen JP. Exploring the association between rosacea and Parkinson disease: a Danish nationwide cohort study. JAMA Neurol. 2016;73(5):529–34.

    Article  Google Scholar 

  19. Lyon S, Majewski S, Guido N, Ibler E, Huynh T, Rangel S, et al. LB766 Parkinson’s disease association with rosacea: a large, single center, retrospective study. J Investig Dermatol. 2016;136:B3.

    Article  Google Scholar 

  20. Mathieu RJ, Guido N, Ibler E, Serrano L, Rangel SM, Schlosser BJ, et al. Rosacea and subsequent diagnosis for Parkinson’s disease: a large, urban, single center, US patient population retrospective study. J Eur Acad Dermatol Venereol. 2018;32(4):e141–4.

    Article  CAS  Google Scholar 

  21. Chen X, Feng D, Schwarzschild MA, Gao X. Red hair, MC1R variants, and risk for Parkinson’s disease–a meta-analysis. Ann Clin Transl Neurol. 2017;4(3):212–6.

    Article  CAS  Google Scholar 

  22. Liu Y, Sheikh MS. Melanoma: molecular pathogenesis and therapeutic management. Mol Cell Pharmacol. 2014;6(3):228.

    PubMed  PubMed Central  Google Scholar 

  23. Rastrelli M, Tropea S, Rossi CR, Alaibac M. Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. In Vivo. 2014;28:1005–11.

    PubMed  Google Scholar 

  24. Liu R, Gao X, Lu Y, Chen H. Meta-analysis of the relationship between Parkinson disease and melanoma. Neurology. 2011;76(23):2002–9.

    Article  Google Scholar 

  25. Bertoni JM, Arlette JP, Fernandez HH, Fitzer-Attas C, Frei K, Hassan MN, et al. Increased melanoma risk in Parkinson disease: a prospective clinicopathological study. Arch Neurol. 2010;67(3):347–52.

    Article  Google Scholar 

  26. Gao X, Simon KC, Han J, Schwarzschild MA, Ascherio A. Genetic determinants of hair color and Parkinson’s disease risk. Ann Neurol. 2009;65:76–82.

    Article  Google Scholar 

  27. Pan T, Zhu J, Hwu W-J, Jankovic J. The role of α-synuclein in melanin synthesis in melanoma and dopaminergic neuronal cells. PLoS One. 2012;7:e45183.

    Article  CAS  Google Scholar 

  28. Pfeiffer RF. Management of autonomic dysfunction in Parkinson’s disease. Semin Neurol. 2017;37(02):176–85 Thieme Medical Publishers.

    Article  Google Scholar 

  29. Zhao CY, Murrell DF. Advances in understanding and managing bullous pemphigoid. F1000Res. 2015;4:F1000 1–7.

    Google Scholar 

  30. Langan SM, Smeeth L, Hubbard R, Fleming KM, Smith CJP, West J, et al. Bullous pemphigoid and pemphigus vulgaris—incidence and mortality in the UK: population based cohort study. BMJ. 2008;337:a180.

    Article  CAS  Google Scholar 

  31. Joly P, Baricault S, Sparsa A, Bernard P, Bédane C, Duvert-Lehembre S, et al. Incidence and mortality of bullous pemphigoid in France. J Investig Dermatol. 2012;132(8):1998–2004.

    Article  CAS  Google Scholar 

  32. Cordel N, Chosidow O, Hellot MF, Delaporte E, Lok C, Vaillant L, et al. Neurological disorders in patients with bullous pemphigoid. Dermatology. 2007;215:187–91.

    Article  Google Scholar 

  33. •• Brick KE, Weaver CH, Savica R, Lohse CM, Pittelkow MR, Boeve BF, et al. A population-based study of the association between bullous pemphigoid and neurologic disorders. J Am Acad Dermatol. 2014;71(6):1191–7 A case control and retrospective review which demonstrates a significantly increased risk of bullous pemphigoid development in those patients previously diagnosed with any type of neurological disorder.

    Article  Google Scholar 

  34. Milani-Nejad N, Zhang M, Kaffenberger J. The association between bullous pemphigoid and neurological disorders: a systematic review. Eur J Dermatol. 2017;27(5):472–81.

    PubMed  Google Scholar 

  35. Chen J, Li L, Chen J, Zeng Y, Xu H, Song Y, et al. Sera of elderly bullous pemphigoid patients with associated neurological diseases recognize bullous pemphigoid antigens in the human brain. Gerontology. 2011;57(3):211–6.

    Article  Google Scholar 

  36. Bastuji-Garin S, Joly P, Lemordant P, et al. Risk factors for bullous pemphigoid in the elderly: a prospective case-control study. J Investig Dermatol. 2011;131:637–43.

    Article  CAS  Google Scholar 

  37. Tarazona MJM, Mota ANC de M, Gripp AC, Unterstell N, Bressan AL. Bullous pemphigoid and neurological disease: statistics from a dermatology service. An Bras Dermatol. 2015;90(2):280–2.

    Article  Google Scholar 

  38. •• Försti A-K, Jokelainen J, Ansakorpi H, et al. Psychiatric and neurological disorders are associated with bullous pemphigoid – a nationwide Finnish Care Register study. Sci Rep. 2016;6:37125 A nationwide Finnish retrospective review which demonstrates a nearly six times odds ratio increase of bullous pemphigoid development after diagnosis of multiple sclerosis.

    Article  Google Scholar 

  39. Rodríguez-Leyva I, Chi-Ahumada EG, Carrizales J, et al. Parkinson disease and progressive supranuclear palsy: protein expression in skin. Ann Clin Transl Neurol. 2016;3(3):191–9.

    Article  Google Scholar 

  40. Siepmann T, Penzlin AI, Illigens BM-W, Reichmann H. Should skin biopsies be performed in patients suspected of having Parkinson’s disease? Parkinsons Dis. 2017:1–6.

    Article  Google Scholar 

  41. Langan SM, Groves RW, West J. The relationship between neurological disease and bullous pemphigoid: a population-based case–control study. J Investig Dermatol. 2011;131(3):631–6.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Duke University Medical School, Durham, USA

    John Tanaka

  2. Duke Health, Department of Dermatology, Durham, USA

    Christopher Henderson & Matilda W. Nicholas

Authors
  1. John Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher Henderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Matilda W. Nicholas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matilda W. Nicholas.

Ethics declarations

Conflict of Interest

John Tanaka, Christopher Henderson, and Matilda Nicholas declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Dermatology and Wound Care

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tanaka, J., Henderson, C. & Nicholas, M.W. Skin Disease and Neurological Conditions of the Elderly. Curr Geri Rep 7, 238–242 (2018). https://doi.org/10.1007/s13670-018-0263-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13670-018-0263-z

Keywords

Search

Navigation