Skin Disorders in the Elderly

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk


There are two types of ageing of the skin. One is intrinsic and is attributable to the passage of time and the other extrinsic caused by environmental factors such as chronic exposure to sunlight (photoageing). The former moves at a genetically determined pace. With ageing structural and functional changes occur in all the structures of the skin. The epidermis, dermis and the subcutaneous layers become thinned out, the keratinocytes shrink and there is a decrease in the number of melanocytes, Langerhans cells and Merkel cells. There is a reduction in the fibroblasts as well as nerve endings, blood vessels and exocrine sweat glands. Exposure of the skin to UV light over several years is associated with the development of skin cancers. Cellular pathways with a high frequency of mutations include p53 and extensive UV exposure causes mutation of p53 gene. The melanocytic malignancies have been categorised as subgroups which include the BRAS-, NRAS- and KIT-mutated melanomas. The RAS/BRAF/MAPK pathway is a common site for genetic deviations in melanoma. Skin diseases in the elderly are more often than not the effects of sun damage or vascular disease. In the elderly the common dermatoses seen are xerosis, pruritus, eczematous dermatitis, stasis dermatitis and fungal and viral infections. Immunosenescence leads to similar levels of occurrence of autoimmune skin disorders such as bullous pemphigoid, paraneoplastic pemphigus and pemphigus vulgaris and in older women lichen sclerosus and potential reactivation of the zoster virus. These autoimmune skin disorders result from either the production of antibodies that react with the host tissue or to autoreactivity of the immune effector T cells.


Age-related changes Skin disorders Melanoma Autoimmune skin disorders Pruritus 


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 2
  • Gary Cheuk
    • 3
  1. 1.Sydney Medical School (Westmead)The University of SydneyNorth RocksAustralia
  2. 2.Norwest Specialist Medical GroupBella VistaAustralia
  3. 3.Blacktown-Mt Druitt HospitalBlacktownAustralia

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