Skip to main content
SpringerLink
Log in

Geriatric Skin and Dermatosis

  • Chapter
  • First Online:
Advanced Age Geriatric Care

  • 1423 Accesses

Abstract

Common geriatric dermatoses include xerosis and asteatotic dermatitis, chronic pruritus, seborrhoeic dermatitis, venous eczema, bullous pemphigoid, drug eruptions, skin changes resulting from the effects of chemical and mechanical trauma on fragile skin and infections such as herpes zoster and tinea. There is also an increased incidence of benign and malignant neoplasms. Common benign growths include seborrhoeic keratoses, Campbell de Morgan spots, fibroepitheliomas and lentigines. The incidence of certain malignant skin tumours increases with age, principally basal cell carcinoma, squamous cell carcinoma and melanoma. This chapter provides information on skin conditions that are common to this population with main focus on the management.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mastrolonardo M, Diaferio A, Vendemiale G, Lopalco P. Seborrhoeic dermatitis in the elderly: inferences on the possible role of disability and loss of self-sufficiency. Acta Derm Venereol. 2004;84(4):285–7.

    Article  Google Scholar 

  2. Berger T, Shive M, Harper MG. Pruritis in the older patient: a clinical review. JAMA. 2013;310(22):2443–50.

    Article  CAS  Google Scholar 

  3. Schmidt E, Zillikens D. Pemphigoid diseases. [Review]. Lancet. 2013;381(9863):320–32.

    Article  Google Scholar 

  4. Zalaudek I, Lallas A, Longo C, Moscarella E, Tiodorovic-Zivkovic D, Ricci C, Albertini G, Argenziano G. Problematic lesions in the elderly. Dermatol Clin. 2013;31(4):549–64.

    Article  CAS  Google Scholar 

  5. Lasithiotakis KG, Petrakis IE, Garbe C. Cutaneous melanoma in the elderly: epidemiology, prognosis and treatment. Melanoma Res. 2010;20(3):163–70.

    PubMed  Google Scholar 

  6. Farage MA, Miller KW, Elsner P, Maibach HI. Characteristics of aging skin. Adv Wound Care. 2013;2(1):5–10.

    Article  Google Scholar 

  7. Kohl E, Steinbauer J, Landthaler M, Szeimies R-M. Skin ageing. J Euro Acad Dermatol Venereol. 2011;25(8):873–84.

    Article  CAS  Google Scholar 

  8. Montagna W, Carlisle L. Structural changes in aging skin. Br J Dermatol. 1990;122(Suppl 35):61–70.

    Article  Google Scholar 

  9. Nagaratnam N, Nagaratnam K, Cheuk G. Skin disorders in the elderly. In: Diseases in the elderly. Age –related changes and pathophysiology. New York: Springer; 2016. p. 215–26.

    Google Scholar 

  10. Kottner J, Lichterfeld A, Blume-Peytavi U. Maintaining skin integrity in the aged: a systemic review. Br J Dermatol. 2013;169(3):528–42.

    Article  CAS  Google Scholar 

  11. Konda D, Chandrashekar L, Rajappa M, Kattimani S, Thappa DM, Ananthanarayanan PH. Serotonin and interleukin-6: association with pruritus severity, sleep quality and depression severity in Prurigo Nodularis. Asian J Psychiatr. 2015;17:24–8.

    Article  Google Scholar 

  12. Valdes-Rodriguez R, Stull C, Yosipovitch G. Chronic pruritis in the elderly: pathophysiology, diagnosis and management. Drugs Aging. 2015;32:201–15.

    Article  CAS  Google Scholar 

  13. Pereira MP, Stander S. Assessment of severity and burden of pruritis. Allergol Int. 2017;66(1):3–7.

    Article  Google Scholar 

  14. Weisshaar E, Apfelbacher C, Jager G, Zimmermann E, Bruckner T, Diepgen TL, Gollnick H. Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients. Br J Dermatol. 2006;155(5):957–64.

    Article  CAS  Google Scholar 

  15. Pereira MP, Kremer AE, Mettang T, Stander S. Chronic pruritis in the absence of skin disease: pathophysiology, diagnosis and treatment. Am J Clin Dermatol. 2016;17(4):337–48.

    Article  Google Scholar 

  16. Jafferany M, Huynh TV, Silverman MA, Zaidi Z. Geriatric dermatoses: a clinical review of skin diseases in an aging population. Int J Dermatol. 2012;51(5):509–22.

    Article  Google Scholar 

  17. Abraham A, Roga G. Topical steroid-damaged skin. Indian J Dermatol. 2014;59(5):456–9.

    Article  Google Scholar 

  18. Rathi SK, D’Souza P. Rational and ethical use of topical corticosteroids based on safety and efficacy. Indian J Dermatol. 2012;57(4):251–9.

    Article  Google Scholar 

  19. Siemens W, Xander C, Meerpohl JJ, Buroh S, Antes G, Schwarzer G, Becker G. Pharmacological interventions for pruritis in adult palliative care patients. Cochrane Database Syst Rev. 2016;11:CD008320.

    PubMed  Google Scholar 

  20. Stull C, Lavery M, Yosipovitch G. Advances in the therapeutic strategies for the treatment of pruritis. Expert Opin Pharmacother. 2016;17(5):671–87.

    Article  CAS  Google Scholar 

  21. White-Chu EF, Reddy M. Dry skin in the elderly: complexities of a common problem. Clin Dermatol. 2011;29(1):37–42.

    Article  Google Scholar 

  22. Li LF, Lan YZ. Bathing and generalized asteatotic eczema: a case-control study. Br J Dermatol. 2008;159(1):243–5.

    Article  Google Scholar 

  23. Sparsa A, Liozon E, Boulinguez S, Bordessoule D, Vidal E, Bonnetblanc JM, Bedane C. Generalized eczema craquele as a presenting feature of systemic lymphoma: report or seven cases. Acta Derm Venereol. 2005;85(4):333–6.

    Article  Google Scholar 

  24. Norman RA. Xerosis and pruritis in the elderly: recognition and management. Dermatol Ther. 2003;16(3):254–9.

    Article  Google Scholar 

  25. Comert A, Akbas B, Kilic EZ, Akin O, Gokce E, Goktuna Z, Taskapan O. Psychiatric comorbidities and alexithymia in patients with seborrheic dermatitis: a questionnaire study in Turkey. Am J Clin Dermatol. 2013;14(4):335–42.

    Article  Google Scholar 

  26. Arsic Arsenijevic VS, Milobratovic D, Barac AM, Vekic B, Marinkovic J, Kostic VS. A laboratory-based study on patients with Parkinson’s disease and seborrheic dermatitis: the presence and density of Malassezia yeasts, their different species and enzymes production. BMC Dermatol. 2014;14:5.

    Article  Google Scholar 

  27. Nazarko L. Diagnosis and treatment of venous eczema. Br J Community Nurs. 2009;14(5):188–94.

    Article  Google Scholar 

  28. Goldsmith LA, Katz SL, Gilchrest BA, Paller AS, Leffell DJ, Fitzpatrick’s WK. Dermatology in general medicine. 8th ed: NewYork, USA: McGraw-Hill; 2012. p. 2112–3.

    Google Scholar 

  29. Ukat A, Konig M, Vanscheidt W, Munter KC. Short-stretch versus multilayer compression for venous leg ulcers: a comparison of healing rates. J Wound Care. 2003;12(4):139–43.

    Article  CAS  Google Scholar 

  30. Beechey R, Priest L, Peters M, Moloney C. An evidence-based approach to the prevention and initial management of skin tears within the aged community setting: a best practice implementation project. JBI Database System Rev Implement Rep. 2015;13(5):421–43.

    PubMed  Google Scholar 

  31. Seyfarth F, Schliemann S, Antonov D, Elsner P. Dry skin, barrier function, and irritant contact dermatitis in the elderly. Clin Dermatol. 2011;29(1):31–6.

    Article  Google Scholar 

  32. Mick G. Vaccination: a new option to reduce the burden of herpes zoster. Expert Rev Vaccines. 2010;9(3 Suppl):31–5.

    Article  Google Scholar 

  33. Askari SK, Schram SE, Wenner RA, Bowers S, Liu A, Bangerter AK, Warshaw EM. Evaluation of prospectively collected presenting signs/symptoms of biopsy-proven melanoma, basal cell carcinoma, squamous cell carcinoma, and seborrheic keratosis in an elderly male population. J Am Acad Dermatol. 2007;56(5):739–47.

    Article  Google Scholar 

  34. Shumack SP. Non-surgical tratments for skin cancer. Aust Prescr. 2011;34:6–7.

    Article  Google Scholar 

  35. Bowman PH, Ratz JL, Knoepp TG, Barnes CJ, Finley EM. Basosquamous carcinoma. Dermatol Surg. 2003;29:830–3.

    PubMed  Google Scholar 

  36. Glogau RG. The risk of progression to invasive disease. J Am Acad Dermatol. 2000;42(1 Pt 2):23–4.

    Article  CAS  Google Scholar 

  37. Lee MM, Wick MM. Bowens disease. CA Cancer J Clin. 1990;40(4):237–42.

    Article  CAS  Google Scholar 

  38. Amini S1, Viera MH, Valins W, Berman B. Nonsurgical innovations in the treatment of nonmelanoma skin cancer. J Clin Aesthet Dermatol. 2010;3(6):20–34.

    PubMed  PubMed Central  Google Scholar 

  39. Laurin Council M. Common skin cancers in older patients: approach to diagnosis and management. Clin Geriatr Med. 2013;29(2):361–72.

    Article  Google Scholar 

  40. L M, Ramasamy S, Robert F. Weekly radiotherapy for basal cell carcinoma in the frail and elderly. Br J Dermatol. 2014;171(5):1237–9.

    Article  Google Scholar 

  41. Pelissero A, Elvio GR, Melano A, Fillini C, Vigna-Taglianti R, Settineri N, et al. Facial basal cell carcinomas treated with hypo-fractionated radiotherapy: a retrospective analysis in 117 elderly patients. J Am Acad Dermatol. 2015;73(1):166–8.

    Article  Google Scholar 

  42. Goldringer SM, Murer C, Sieger P, Dummer R. Targeted therapy in melanoma – the role of BRAF, RAS, and KIT mutations. Eur J Cancer Suppl. 2013;11(2):92–6.

    Article  Google Scholar 

  43. Awad MM, Sullivan RJ. Dabrafenib in combination with trametinib for the treatment of metastatic melanoma. Expert Rev Clin Pharmacol. 2015;8(1):25–33.

    Article  Google Scholar 

  44. Atkins M. Immunotherapy combinations with checkpoint inhibitors in metastatic melanoma: current approaches and future directions. Semin Oncol. 2015;42(Suppl 3):S12–9.

    Article  CAS  Google Scholar 

  45. Keller FC, McAarthur GA. Targeting NRAS in melanoma. Cancer J. 2012;18(2):132–6.

    Article  Google Scholar 

  46. Dummer R, Goldinger SM, Paulitschke V, Levesque MP. Curing advanced melanoma by 2025. Curr Opin Oncol. 2015;27(2):125–7.

    Article  CAS  Google Scholar 

  47. Robert C, Ribas A, Wolchok JD, et al. Anti-programmed death receptor 1 treatment with pembrolizumab in ipilumumab refractory advanced melanoma: a randomised dose comparison cohort of a phase 1 trial. Lancet. 2014;384:1109–17.

    Article  CAS  Google Scholar 

  48. Smalberger GJ, Siegel DM, Khachemoune A. Lentigo maligna. Dermatol Ther. 2008;21(6):439–46.

    Article  Google Scholar 

  49. Kallini JR, Jain SK, Khachemoune A. Lentigo maligna: review of salient characteristics and management. Am J Clin Dermatol. 2013;14(6):473–80.

    Article  Google Scholar 

  50. Read T, Noonan C, David M, Wagels M, Foote M, Schaider H, Soyer HP, Smithers BM. A systematic review of non-surgical treatments for lentigo maligna. J Euro Acad Dermatol Venereol. 2016;30(5):748–53.

    Article  CAS  Google Scholar 

  51. Weinstock MA, Sober AJ. The risk of progression of lentigo maligna to lentigo maligna melanoma. Br J Dermatol. 1987;116:303–10.

    Article  CAS  Google Scholar 

  52. Fogarty GB, Hong A, Scolyer RA, Lin E, Haydu L, Guitera P, Thompson J. Radiotherapy for lentigo maligna: a literature review and recommendations for treatment. [Review]. Br J Dermatol. 2014;170(1):52–8.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orange Dermatology, Orange, NSW, Australia

    Derek Davies

Authors
  1. Derek Davies
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Derek Davies .

Editor information

Editors and Affiliations

  1. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Nages Nagaratnam

  2. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Kujan Nagaratnam

  3. Rehabilitation and Aged Care Service, Blacktown-Mt Druitt Hospital, Blacktown, NSW, Australia

    Gary Cheuk

Multiple Choice Questions

Multiple Choice Questions

  1. 1.

    The following are true of pruritus, except:

    1. A.

      Pruritus without rash is not caused by xerosis.

    2. B.

      Drug-induced itch may persist for several weeks or even months following cessation of the suspect medication.

    3. C.

      The most common aetiological agents causing pruritus are calcium channel blockers, thiazides and codeine.

    4. D.

      Systemic treatments including sedating antihistamines are helpful for patients experiencing nocturnal itch.

  2. 2.

    The following are true of malignant lentigo maligna, except:

    1. A.

      Lentigo maligna are most common after the seventh decade.

    2. B.

      They occur in chronically sun-exposed areas.

    3. C.

      Radiotherapy is a safe, well-tolerated and effective treatment modality.

    4. D.

      Topical imiquimod is the gold standard for treatment.

  3. 3.

    The following are true of non-melanoma skin cancer, except:

    1. A.

      Merkel cell carcinomas are common in the elderly.

    2. B.

      Basal cell carcinomas rarely metastasize.

    3. C.

      Actinic keratoses are a precursor to squamous cell carcinoma.

    4. D.

      Morphoeic BCCs have a sclerotic or scar-like appearance.

  4. 4.

    The following are true of pruritus, except:

    1. A.

      Xerosis is the most common cause of itch in elderly patients.

    2. B.

      Pruritus may occur as a paraneoplastic phenomenon.

    3. C.

      Severe pruritus causes as much discomfort as chronic pain.

    4. D.

      Drug-induced itch is usually not associated with rash.

Answers to MCQs

  1. 1.

    A

  2. 2.

    D

  3. 3.

    A

  4. 4.

    D

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Davies, D. (2019). Geriatric Skin and Dermatosis. In: Nagaratnam, N., Nagaratnam, K., Cheuk, G. (eds) Advanced Age Geriatric Care. Springer, Cham. https://doi.org/10.1007/978-3-319-96998-5_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-96998-5_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96997-8

  • Online ISBN: 978-3-319-96998-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation