European Journal of Dermatology

, Volume 26, Issue 5, pp 470–476 | Cite as

Skin tumours and skin aging in 209 French elderly people: the PROOF study

  • Elisa CinottiEmail author
  • Jean Luc Perrot
  • Bruno Labeille
  • Anne Catherine Biron
  • Andrea Vierkötter
  • Catherine Heusèle
  • Carine Nizard
  • Sylvianne Schnebert
  • Jean Claude Barthelemy
  • Frédéric Cambazard
Clinical report



Few studies have evaluated the prevalence of skin tumours in the geriatric population and none have analysed different skin aging parameters for whole-body skin in this population.


To evaluate the prevalence of skin tumours and global skin aging in a French cohort of elderly people.

Materials and methods

In total, 209 subjects, 105 women and 104 men (mean age: 77.5; range: 74-81 years), were enrolled from the PROOF (PROgnostic indicator OF cardiovascular and cerebrovascular events) cohort. SCINEXA (SCore for INtrinsic and EXtrinsic skin Aging) was used to assess the degree of skin aging and the prevalence of skin tumours. Some additional cutaneous parameters were also studied. Skin aging in women and men was compared.


Mean global SCINEXA was 24.3 (SD: 4.7; range: 8.2-35.3). Solar elastosis and lax appearance were more severe in women (t test; p<0.0001), whereas pseudoscars (t test; p = 0.0312) and coarse wrinkles (t test; p = 0.0479) were more severe in men. Erythrosis coli (chi-square test; p <0.0001) was more frequent in men, whereas varicous veins (chi-square test; p = 0.0026) and eyelid xanthomas (chi-square test; p = 0.0282) were more frequent in women. Twelve patients presented with cutaneous carcinomas and two patients had early melanomas.


This research describes in detail the main indices of skin aging in an old population and the differences related to gender. Moreover, it highlights the utility of systematic screening of old patients by dermatologists in order to diagnose skin cancers early.

Key words

aging melanoma elderly people prevalence skin SCINEXA tumor 


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  1. 1.
    Diepgen TL. Demographic changes in Germany. Consequences in health policy and dermatology. Hautarzt 2003; 54: 804–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Twigg J, Majima S. Consumption and the constitution of age: expenditure patterns on clothing, hair and cosmetics among post-war ‘baby boomers’. J Aging Stud 2014; 30: 23–32.CrossRefPubMedGoogle Scholar
  3. 3.
    Templier C, Boulanger E, Boumbar Y, et al. Systematic skin examination in an acute geriatric unit: skin cancer prevalence. Clin Exp Dermatol 2015; 40: 356–60.CrossRefPubMedGoogle Scholar
  4. 4.
    Fontaine J, Mielczarek S, Meaume S, Senet P. Incidence of undiagnosed skin cancers in a geriatric hospital. Ann Dermatol Venereol 2008; 135: 651–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Deo MS, Kerse N, Vandal AC, Jarrett P. Dermatological disease in the older age group: a cross-sectional study in aged care facilities. BMJ Open 2015; 5: e009941.CrossRefGoogle Scholar
  6. 6.
    Barthélémy J-C, Pichot V, Dauphinot V, et al. Autonomic nervous system activity and decline as prognostic indicators of cardiovascular and cerebrovascular events: the ‘PROOF’ Study. Study design and population sample. Associations with sleep-related breathing disorders: the ‘SYNAPSE’ Study. Neuroepidemiology 2007; 29: 18–28.CrossRefPubMedGoogle Scholar
  7. 7.
    Martin MS, Sforza E, Roche F, Barthélémy JC, Thomas-Anterion C, & PROOF study group. Sleep breathing disorders and cognitive function in the elderly: an 8-year follow-up study. The proof-synapse cohort. Sleep 2015; 38: 179–87.PubMedGoogle Scholar
  8. 8.
    Sforza E, Roche F, Thomas-Anterion C, et al. Cognitive function and sleep related breathing disorders in a healthy elderly population: the SYNAPSE study. Sleep 2010; 33: 515–21.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Vierkötter A, Ranft U, Krämer U, et al. The SCINEXA: a novel, validated score to simultaneously assess and differentiate between intrinsic and extrinsic skin ageing. J Dermatol Sci 2009; 53: 207–11.CrossRefPubMedGoogle Scholar
  10. 10.
    Roberts WE. Skin type classification systems old and new. Dermatol Clin 2009; 27: 529–33, viii.CrossRefPubMedGoogle Scholar
  11. 11.
    Longo C, Casari A, De Pace B, et al. Proposal for an in vivo histopathologic scoring system for skin aging by means of confocal microscopy. Skin Res Technol 2013; 19: e167–73.CrossRefGoogle Scholar
  12. 12.
    Raphael AP, Kelf TA, Wurm EMT, et al. Computational characterization of reflectance confocal microscopy features reveals potential for automated photoageing assessment. Exp Dermatol 2013; 22: 458–63.CrossRefPubMedGoogle Scholar
  13. 13.
    Ganceviciene R, Liakou AI, Theodoridis A, et al. Skin anti-aging strategies. Dermatoendocrinol 2012; 4: 308–19.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Kennedy C, Bastiaens MT, Bajdik CD, et al. Effect of smoking and sun on the aging skin. J Invest Dermatol 2003; 120: 548–54.CrossRefPubMedGoogle Scholar
  15. 15.
    Vitellaro-Zuccarello L, Cappelletti S, Dal Pozzo Rossi V, Sari-Gorla M. Stereological analysis of collagen and elastic fibers in the normal human dermis: variability with age, sex, and body region. Anat Rec 1994; 238: 153–62.CrossRefPubMedGoogle Scholar
  16. 16.
    Luebberding S, Krueger N, Kerscher M. Quantification of agerelated facial wrinkles in men and women using a three-dimensional fringe projection method and validated assessment scales. Dermatol Surg 2014; 40: 22–32.CrossRefPubMedGoogle Scholar
  17. 17.
    Clark HM, Solomon NP. Age and sex differences in orofacial strength. Dysphagia 2012; 27: 2–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Paes EC, Teepen HJLJM, Koop WA, Kon M. Perioral wrinkles: histologic differences between men and women. Aesthetic Surg J 2009; 29: 467–72.CrossRefGoogle Scholar
  19. 19.
    Katoulis AC, Stavrianeas NG, Georgala S, et al. Poikiloderma of Civatte: a clinical and epidemiological study. J Eur Acad Dermatol Venereol 2005; 19: 444–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Schäfer T, Merkl J, Klemm E, et al. The epidemiology of nevi and signs of skin aging in the adult general population: results of the KORAsurvey 2000. J Invest Dermatol 2006; 126: 1490–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Piliouras P, Gilmore S, Wurm EM, et al. New insights in naevogenesis: number, distribution and dermoscopic patterns of naevi in the elderly. Australas J Dermatol 2011; 52: 254–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Yeatman JM, Kilkenny M, Marks R. The prevalence of seborrhoeic keratoses in an Australian population: does exposure to sunlight play a part in their frequency? Br J Dermatol 1997; 137: 411–4.CrossRefPubMedGoogle Scholar
  23. 23.
    Kyriakis KP, Alexoudi I, Askoxylaki K, et al. Epidemiologic aspects of seborrheic keratoses. Int J Dermatol 2012; 51: 233–4.CrossRefPubMedGoogle Scholar
  24. 24.
    Chopra A. Skin diseases in the elderly. Indian J Dermatol Venereol Leprol 1999; 65: 245–6.PubMedGoogle Scholar
  25. 25.
    Sayal SK, Rajbhandari S, Malik AK, Gupta CM. A study of dermatological disorders in geriatric age group. Indian J Dermatol Venereol Leprol 1998; 64: 270–2.PubMedGoogle Scholar
  26. 26.
    Patange VS, Fernandez RJ. A study of geriatric dermatoses. Indian J Dermatol Venereol Leprol 1995; 61: 206–8.PubMedGoogle Scholar
  27. 27.
    Beauregard S, Gilchrest BA. A survey of skin problems and skin care regimens in the elderly. Arch Dermatol 1987; 123: 1638–43.CrossRefPubMedGoogle Scholar
  28. 28.
    Tindall JP, Smith JG. Skin lesions of the aged and their association with internal changes. JAMA 1963; 186: 1039–42.CrossRefPubMedGoogle Scholar
  29. 29.
    Shah R, Jindal A, Patel N. Acrochordons as a cutaneous sign of metabolic syndrome: a case-control study. Ann Med Health Sci Res 2014; 4: 202–5.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Hoey SEH, Devereux CEJ, Murray L, et al. Skin cancer trends in Northern Ireland and consequences for provision of dermatology services. Br J Dermatol 2007; 156: 1301–7.CrossRefPubMedGoogle Scholar
  31. 31.
    Katalinic A, Kunze U, Schäfer T. Epidemiology of cutaneous melanoma and non-melanoma skin cancer in Schleswig-Holstein, Germany: incidence, clinical subtypes, tumour stages and localization (epidemiology of skin cancer). Br J Dermatol 2003; 149: 1200–6.CrossRefPubMedGoogle Scholar
  32. 32.
    Pascual JC, Belinchón I, Ramos JM, et al. Skin tumors in patients aged 90 years and older. Dermatol Surg 2004; 30: 1017–9, discussion: 1019–20.PubMedGoogle Scholar
  33. 33.
    Khaled A, Ben Mbarek L, Zeglaoui F, et al. Epidemiologic study of cutaneous cancers in aged persons. Tunis Med 2008; 86: 895–8.PubMedGoogle Scholar
  34. 34.
    Souissi A, Zeglaoui F, El Fekih N, et al. Skin diseases in the elderly: a multicentre Tunisian study. Ann Dermatol Vénéréologie 2006; 133: 231–4.CrossRefGoogle Scholar
  35. 35.
    Liao YH, Chen KH, Tseng MP, Sun CC. Pattern of skin diseases in a geriatric patient group in Taiwan: a 7-year survey from the outpatient clinic of a university medical center. Dermatol Basel Switz 2001; 203: 308–13.CrossRefGoogle Scholar
  36. 36.
    Lubeek SFK, Van Der Geer ER, Van Gelder MMHJ, et al. Dermatologic care of institutionalized elderly patients: a survey among dermatologists in the Netherlands. Eur J Dermatol 2015; 25: 606–12.PubMedGoogle Scholar
  37. 37.
    Mayer JE, Swetter SM, Fu T, Geller AC. Screening, early detection, education, and trends for melanoma: current status (2007-2013) and future directions: Part I. Epidemiology, high-risk groups, clinical strategies, and diagnostic technology. J Am Acad Dermatol 2014; 71: 599, e1-12;quiz 610. 599. e12.PubMedGoogle Scholar
  38. 38.
    Geller AC, Annas GD. Epidemiology of melanoma and nonmelanoma skin cancer. Semin Oncol Nurs 2003; 19: 2–11.CrossRefPubMedGoogle Scholar
  39. 39.
    Helfand M, Mahon S, Eden K. Screening for Skin Cancer. Agency for Healthcare Research and Quality (US); 2001. Available at: (accessed 10 Dec 2015).Google Scholar

Copyright information

© John Libbey Eurotext 2016

Authors and Affiliations

  • Elisa Cinotti
    • 1
    Email author
  • Jean Luc Perrot
    • 1
  • Bruno Labeille
    • 1
  • Anne Catherine Biron
    • 1
  • Andrea Vierkötter
    • 2
  • Catherine Heusèle
    • 3
  • Carine Nizard
    • 3
  • Sylvianne Schnebert
    • 3
  • Jean Claude Barthelemy
    • 4
  • Frédéric Cambazard
    • 1
  1. 1.Department of DermatologyUniversity Hospital of Saint Etienne, Cedex 2Saint EtienneFrance
  2. 2.IUFLeibniz Research Institute for Environmental MedicineDüsseldorfGermany
  3. 3.LVMH ResearchSaint Jean-de-BrayeFrance
  4. 4.Clinical and Exercise Physiology LaboratoryUniversity Hospital of Saint Etienne, Cedex 2Saint EtienneFrance

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