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Overview and Update in Geriatric Dermatology

  • Dermatology and Wound Care (A Chang, Section Editor)
  • Published:
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Abstract

Current literature regarding elderly patient care in dermatology continues to advance and expand due to the increase in population, treatment options, and the associated morbidities. Medical literature in dermatology now includes more topics that focus on treatment of the elderly population in regard to cutaneous and systemic pathologies. Such topics include holistic patient care, integrative medicine, chronic pruritus, autoimmunity, carcinogenic prevention and treatment, and nursing home dermatology. The elderly patients consume a large percentage of pharmaceuticals and experience more comorbidities than other age groups.

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References

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

  1. Aging Statistics. (2016). Retrieved June 14, 2016, from http://www.aoa.acl.gov/Aging_Statistics/index.aspx

  2. MH Omar MBChB(UCT), Dip. Occ. Health (U.S.). Common skin disorders in the elderly. South Af Family Pract. 2006;48(5):29–34. doi:10.1080/20786204.2006.10873392.

    Article  Google Scholar 

  3. Norman, R. A. (2011). Effectively manage older patients with skin diseases. Retrieved June 14, 2016, from: http://practicaldermatology.com/2011/09/effectively-manage-older-patients-with-skin-diseases

  4. Thapa DP, Jha AK, Kharel C, Shrestha S. Dermatological problems in geriatric patients: a hospital based study. Nepal Med Coll J. 2012;14(3):193–5.

    CAS  PubMed  Google Scholar 

  5. •• Humbert P, Dréno B, Krutmann J, Luger TA, Triller R, Meaume S, et al. Recommendations for managing cutaneous disorders associated with advancing age. Clin Int Aging. 2016;11:141–8. doi:10.2147/CIA.S96232. The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them.

    Google Scholar 

  6. World Health Association. (2016). World report on aging and health. Retrieved from http://www.who.int/mediacentre/factsheets/fs404/en/

  7. White-Chu EF, Reddy M. Dry skin in the elderly: complexities of a common problem. Clin Dermatol. 2011;29(1):37–42. doi:10.1016/j.clindermatol.2010.07.005.

    Article  PubMed  Google Scholar 

  8. •• Endo, J. O., Norman, R. A., Wong, J. W., & Chang, A. L. (2013). Geriatric dermatology: Part I. Geriatric pharmacology for the dermatologist. J Am Acad Dermatol, 68(4), E1-10. doi:10.1016/j.jaad.2012.10.063. Geriatric pharmacology.

  9. •• Chang ALS, Wong JW, Endo JO, Norman RA. Geriatric dermatology: Part II. Risk factors and cutaneous signs of elder mistreatment for the dermatologist. J Am Acad Dermatol. 2013;68(4):533.e1. Elder abuse.

    Article  Google Scholar 

  10. •• Fontanella D, Grant-Kels JM, Patel T, Norman R. Ethical issues in geriatric dermatology. Clin Dermatol. 2012;30(5):511–5. Ethical issues in geriatric dermatology.

    Article  PubMed  Google Scholar 

  11. Rogers J, Harding C, Mayo A, Banks J, Rawlings A. Stratum corneum lipids: the effect of ageing and the seasons. Arch Dermatol Res. 1996;288(12):765–70. doi:10.1007/bf02505294.

    Article  CAS  PubMed  Google Scholar 

  12. Roberts, W. E. (2014). Geriatric dermatology: a generational approach. Consultant, 842–845. Retrieved June 14, 2016

  13. Nicholls SC. Sequelae of untreated venous insufficiency. Semin Int Radiol Sem Int Radiol. 2005;22(03):162–8. doi:10.1055/s-2005-921960.

    Article  Google Scholar 

  14. •• Valdes-Rodriguez R, Stull C, Yosipovitch G. Chronic pruritus in the elderly: pathophysiology, diagnosis and management. Drugs Aging Drugs Aging. 2015;32(3):201–15. doi:10.1007/s40266-015-0246-0. Pruritus in geriatric dermatology.

    Article  CAS  PubMed  Google Scholar 

  15. Ishiuji Y, Coghill R, Patel T, Oshiro Y, Kraft R, Yosipovitch G. Distinct patterns of brain activity evoked by histamine-induced itch reveal an association with itch intensity and disease severity in atopic dermatitis. Br J Dermatol. 2009;161(5):1072–80. doi:10.1111/j.1365-2133.2009.09308.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Berger TG, Steinhoff M. Pruritus in elderly patients—eruptions of senescence. Semin Cutaneous Med Surg. 2011;30(2):113–7. doi:10.1016/j.sder.2011.04.002.

    Article  CAS  Google Scholar 

  17. Gieler U, Gieler T, Schut C, Niemeier V, Peters EM, Kupfer J. Quality of life and comorbidities in urticaria: what is known? Curr Dermatol Rep. 2015;4(2):77–82. doi:10.1007/s13671-015-0105-6.

    Article  Google Scholar 

  18. Petrou, I. (2013). Integrative dermatology is underused in Western medicine. Dermatology Times. Retrieved June 14, 2016, from http://dermatologytimes.modernmedicine.com/dermatology-times/content/tags/dermatology/integrative-dermatology-underused-western-medicine

  19. Valdes-Rodriguez R, Stull C, Yosipovitch G. Chronic pruritus in the elderly: pathophysiology, diagnosis and management. Drugs Aging. 2015;32(3):201–15. doi:10.1007/s40266-015-0246-0.

  20. Williams, M. R., & Gallo, R. L. (2015). The role of the skin microbiome in atopic dermatitis. Curr Allergy Asthma Rep Current Allergy and Asthma Reports, 15(11). doi:10.1007/s11882-015-0567-4

  21. Waldor, M. K., Tyson, G., Borenstein, E., Ochman, H., Moeller, A., Finlay, B. B., … Smith, H. (2015). Where next for microbiome research? PLoS Biology,13(1), e1002050. doi:10.1371/journal.pbio.1002050

  22. Ying, S., Zeng, D.-N., Chi, L., Tan, Y., Galzote, C., Cardona, C., … Quan, Z.-X. (2015). The influence of age and gender on skin-associated microbial communities in urban and rural human populations. PLoS ONE, 10(10), e0141842. doi:10.1371/journal.pone.0141842

  23. Culton DA, Diaz LA. Treatment of subepidermal immunobullous diseases. Clin Dermatol. 2012;30(1):95–102. doi:10.1016/j.clindermatol.2011.03.015.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Singh S. Evidence-based treatments for pemphigus vulgaris, pemphigus foliaceus, and bullous pemphigoid: a systematic review. Ind J Dermatol Venereol Leprol. 2011;77:456–69.

    Article  Google Scholar 

  25. Pemphigus vulgaris antigen, a desmoglein type of cadherin, is localized within keratinocyte desmosomes. (1993). J Cell Biol, 122(2), 409–415.

  26. Gregoriou S, Efthymiou O, Stefanaki C, Rigopoulos D. Management of pemphigus vulgaris: challenges and solutions. Clin Cosmet Investig Dermatol. 2015;8:521–7. doi:10.2147/CCID.S75908.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Sinha AA, Hoffman MB, Janicke EC. Pemphigus vulgaris: approach to treatment. Eur J Dermatol. 2015;25(2):103–13.

    PubMed  Google Scholar 

  28. Skin disorders in older adults: papulosquamous and bullous diseases, Part 1. (2011). Consultant, 51(3), 25–29. Retrieved June 14, 2016, from http://www.consultant360.com/content/skin-disorders-older-adults-papulosquamous-and-bullous-diseases-part-1

  29. Rook AH, Heald PW, Nahass GT, Macey W, Witmer WK, Lazarus GS, et al. Treatment of autoimmune disease with extracorporeal photochemotherapy: pemphigus vulgaris—preliminary report. Yale J Biol Med. 1989;62(6):647–52.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Norman R, Young E Atlas of Geriatric Dermatology Springer-Verlag 2013. Bullous Pemphigoid pp. 37–38

  31. Hegde UP, Chakraborty N, Mukherji B, Kels JM. Metastatic melanoma in the older patient: immunologic insights and treatment outcomes. Exp Rev Pharma Outcomes Res. 2011;11(2):185–93. doi:10.1586/erp.11.14.

    Google Scholar 

  32. Macdonald JB, Dueck AC, Gray RJ, Wasif N, Swanson DL, Sekulic A, et al. Malignant melanoma in the elderly: different regional disease and poorer prognosis. J Cancer. 2011;2:538–43.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lasithiotakis KG, Petrakis IE, Garbe C. Cutaneous melanoma in the elderly: epidemiology, prognosis and treatment. Melanoma Res. 2010;20(3):1. doi:10.1097/cmr.0b013e328335a8dd.

    Article  Google Scholar 

  34. Gagnon, L. (2016). Melanoma treatment: Surgery is not obsolete. Dermatology Times. Retrieved June 14, 2016, from http://dermatologytimes.modernmedicine.com/dermatology-times/news/melanoma-treatment-surgery-not-obsolete?page=0,0

  35. Erdei E, Torres SM. A new understanding in the epidemiology of melanoma. Expert Rev Anticancer Ther. 2010;10(11):1811–23. doi:10.1586/era.10.170.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Otrompke, J. (2009). Melanoma: why older patients may fare better. The Dermatologist, 17(11). Retrieved June 14, 2016, from http://www.the-dermatologist.com/content/melanomawhy-older-patients-may-fare-better

  37. •• Chang L Recent advances in skin cancer treatment in older adults ALS Chang (ed) Springer 2015 Advances in Geriatric Dermatol 97–103. Skin cancer in geriatric dermatology

  38. Ryan KE, Chiang C. Hedgehog secretion and signal transduction in vertebrates. J Biol Chem. 2012;287:17905–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Tang JY, Mackay-Wiggan JM, Aszterbaum M, et al. Inhibiting the hedgehog pathway in patients with the basal-cell nevus syndrome. N Engl J Med. 2012;366:2180–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Epstein EH. Basal cell carcinomas: attack of the hedgehog. Nat Rev Cancer. 2008;8:743–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Von Hoff DD, LoRusso PM, Rudin CM, et al. Inhibition of the hedgehog pathway in advanced basal-cell carcinoma. N Engl J Med. 2009;361:1164–72.

    Article  Google Scholar 

  42. •• Lai O, Endo J Dermato-pharmacology in Older Patients Adults ALS Chang (ed) Springer 2015 Advances in Geriatric Dermatology pp 1–30. Dermato-pharmacology issues in geriatric dermatology

  43. •• Norman R Long-Term Care Dermatology ALS Chang (ed) Springer 2015 Springer 2015 Advances in Geriatric Dermatology pp 77–87. Nursing home geriatric dermatology

  44. 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(12), e009941. doi:10.1136/bmjopen-2015-009941.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Smith DR, Sheu HM, Hsieh FS, Lee YL, Chang SJ, Guo YL. Prevalence of skin disease among nursing home patients in southern Taiwan. Int J Dermatol. 2002;41(11):754–9.

    Article  PubMed  Google Scholar 

  46. Smith DR, Atkinson R, Tang S, Yamagata Z. A survey of skin disease among patients in an Australian nursing home. J Epidemiol. 2002;12(4):336–40.

    Article  PubMed  Google Scholar 

  47. •• Kim EK, Kim HO, Park YM, Park CJ, Yu DS, Lee JY. Prevalence and risk factors of depression in geriatric patients with dermatological diseases. Ann Dermatol. 2013;25(3):278–84. Geriatric depression with dermatological diseases.

    Article  PubMed  PubMed Central  Google Scholar 

  48. The NIH HMP Working Group, Peterson J, Garges S, Giovanni M, McInnes P, Wang L, et al. The NIH human microbiome project. Genome Research. 2009;19(12):2317–23. doi:10.1101/gr.096651.109.

    Article  PubMed Central  Google Scholar 

  49. Yosipovitch G, Tang MB. Practical management of psoriasis in the elderly. Drugs Aging. 2002;19(11):847–63. doi:10.2165/00002512-200219110-00003.

    Article  PubMed  Google Scholar 

  50. Petrou, I. (2013). Psoriasis in seniors: late-onset disease demonstrates different genetic factors than early-onset. Dermatology Times. Retrieved June 14, 2016, from http://dermatologytimes.modernmedicine.com/dermatology-times/news/tags/dermatology/psoriasis-seniors-late-onset-disease-demonstrates-different

  51. Shenoy P, Harugeri A. Elderly patients’ participation in clinical trials. Perspect Clin Res. 2015;6(4):184–9. doi:10.4103/2229-3485.167099.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Robert A. Norman.

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Martin Walsh, Morgan Naylor, and Robert Norman declare no conflict of interest.

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

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

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Norman, R.A., Walsh, M. & Naylor, M. Overview and Update in Geriatric Dermatology. Curr Geri Rep 5, 275–282 (2016). https://doi.org/10.1007/s13670-016-0191-8

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