Geriatric Skin Disorder Clinical Trial
Official title:
Pattern of Skin Disorders in Geriatric Population
In this study, the investigators attempt to determine the frequency of dermatologic diseases in geriatric patients, and search for seasonal, age-related, gender-related and socio- demographic differences in geriatric patients attending the outpatient clinic of the Department of Dermatology, Venereology and Andrology in Assiut University Hospital.
Geriatric health care has become a worldwide concern, but relatively few statistical studies
are available about geriatric skin diseases (liao et al., 2001). There are published studies
regarding skin disorders among the elderly population from different countries such as
Taiwan, USA, Norway, the Philippines and Turkey (Mcfadden and Hande 1989). All of these
studies are about detecting the prevalence or characteristic pattern of skin diseases, or
identifying past or present skin complaints and the dermatologic findings in the elderly
(Tianco et al.,1992).
Although there is no exact age for getting old, 65 years is usually accepted as the beginning
(Blackman et al., 1999). However, life expectancy is increasing all over the world and the
geriatric population is rising dramatically every year as the medical care improves (Beek and
Jones, 2000). Aging is a complex multifactorial phenomenon in which progressive intrinsic
changes in the skin combine synergistically with cumulative environment insults to produce
both structural and functional disturbances (Beauregard and Gilchrest, 1987).
Two types of skin aging exist, which may be divided into intrinsic aging, which includes
those changes that are due to normal maturity and occur in all individuals, and extrinsic
aging, produced by extrinsic factors such as ultraviolet light exposure, smoking, and
environmental pollutants (Norman, 2001). Better understanding of the underlying mechanisms
accompanying skin aging could constitute the basis for extending the lifespan in good health
(American Geriatrics Society 2015).
The frequencies of some diseases change with advancing age. Incidence of eczematous
dermatitis gradually decreases with age, may be due to more contact with environmental and
physical factors (Havlik et al., 1999).
Population with old aged skin show a decline in the regular functions of skin, including cell
replacement capacity, wound healing, immune responsiveness, decline in appendegeal functions
and DNA repair capacity which may be responsible for the higher incidence of sun-related
diseases and cutaneous malignancies in elderly people. (Yaar and Gilchrest, 1999).
Pruritic skin diseases are the most common dermatological problem in the elderly. Pruritis
can be psychogenic in origin. However, there are a number of dermatological and metabolic
conditions that involve pruritis. Xerosis is the most common underlying dermatological
condition. (Norman, 2003) Decreased mobility, drug-induced disorders, and increased
incidences of many chronic diseases are among the reasons elderly individuals are at
heightened risk for skin diseases. Atherosclerosis, diabetes mellitus, human immunodeficiency
virus (HIV), and congestive heart failure are some disease processes that can be detrimental
to skin. These diseases are known to impede vascular efficiency and decrease immune
responses, thereby reducing the body's ability to heal (Norman, 2001).
Decreased immune surveillance in the elderly provides more opportunity for the development of
bacterial and viral infections in these patients (Elgart, 2002).
Decreases in personal care, epidermal turnover, and immunologic functions are observed,
possibly responsible for the high prevalence of fungal infections (Havlik et al., 1999).
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