Geriatric dermatosis; The concerns of aging skin.

Abstract

Objectives: To study the cutaneous manifestations in elderly and their association with gender. Study Design: Cross Sectional study. Setting: Sir Syed Hospital Karachi. Period: Jan 2016 to Jan 2018. Material & Methods: Total 217 geriatric cases (>60 years; both genders) were included from outdoor dermatology clinic. The previous pregnancy, lactation, severe systemic disease and drug induced skin changes were excluded. The association of skin manifestation with gender was analyzed by Chi-square test with significant p<0.05. Results: Among 217 cases, there were 126(58%) females and 91(42%) males. Mean age was 69.3+4.99 years. Wrinkling was seen in 92%, skin laxity in 54.8%, xerosis (43%), dryness (65%), sagging (46%), pigmentation (37%), eczema (25%), sparse hair (21%), skin atrophy (19%), tinea (13%) and LSC (10%). While  herpes zoster, psoriasis, onychomycosis, tinea corporis ,asteotic eczema in 7%. Folliculitis 6%, scabies and bullous pemphigoid seen in 5%, while lichen planus, actinic elastosis, BCC, Prurigo nodularis in 3%. Cellulitis, pediculosis, Seborrheic Dermatitis and contact dermatitis were seen in 2% followed by 1% cases of warts, candidiasis, photodermatosis and SCC seen in our study. Folliculitis (6%) was the most frequent bacterial infection followed by impetigo (0.9%). Herpes zoster (6.5%) was frequent among viral infections followed by warts (0.9%) and HSV-1 (0.9%). Tinea (13.4%) was most frequent fungal infection followed by onychomycosis (7%) and candidiasis (0.9%). Scabies was most common parasitic infection (4.6%) followed by pediculosis (2.3%). Eczema seen in 24.8%. The benign dermatosis, Actinic elastosis was frequent (3.2%), stucco keratosis 4(1.8%), Keratoacanthoma (0.9%). Amongst malignancies, BCC was common (3.2%), followed by SCC (1.4%). 5% Bullous Pemphigoid cases were found. The psychocutaneous disorder included LSC (10%), prurigo nodularis (2.8%) and neurotic excoriation (0.9%). Wrinkling, sagging, dryness of skin, actinic keratosis, actinic elastosis was found to be associated with female gender, however cellulitis, squamous cell carcinoma and asteatotic eczema with male gender. Conclusion: Geriatric population is facing multiple dermatological concerns. Contributory factors being the natural aging process, exposure to UV radiation, pathogens, dryness, humidity, temperature and chemical irritants. Female geriatrics are prone to wrinkling, sagging, dryness of skin and male geriatrics to basal cell carcinoma. There is need to address the skin problems in elderly for better quality of life in geriatrics.