Review article
Skin Infections and Infestations in Geriatric Patients

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Herpes Simplex

Herpes simplex is caused by one of two viruses: Herpes simplex virus 1 (HSV-1), which usually produces a disease around the mouth, and HSV-2, which usually causes disease around the genitalia. When the infection site is incorrect for the virus, it seems to fade out after an episode or two. When the correct site is involved, a recurrent disease may be established.

One problem is that not everyone who has the infection is symptomatic. In fact, it has been found that approximately 85% of adults

Sexually Transmitted Diseases

Traditional STDs and HIV infection definitely occur in the elderly, and their diagnosis is often delayed or missed completely due to lack of suspicion on the part of the physician. Good health into the latter decades of life, prolonged widowhood, and changing social mores all probably contribute to the increasing incidence of STDs among the elderly17, 19; however, reliable statistics are unavailable. A high index of suspicion and appropriate testing is critical to the diagnosis of these

Impetigo and Folliculitis

In older individuals, staphylococci are often cultured from lesions of impetigo, whereas, in children, streptococci are usually found (sometimes mixed with staphylococci). While awaiting culture results, a penicillinase-resistant semisynthetic penicillin or erythromycin should be used to treat these infections in older age groups.12 Although most cases of folliculitis in geriatric patients are caused by the Staphylococcus aureus organism, other pathogens should be considered in patients who do

Lice

Of the three types of lice that cause human infestation, head lice seem to affect children, pubic lice (an STD) affect mostly young adults, and body lice are seen perhaps most often in the elderly. Reclusive or destitute individuals who change clothes infrequently seem to be at highest risk. The diagnosis should be considered particularly when such a patient complains of pruritus and presents with excoriations and bite reactions, especially in “breakfast, lunch, and dinner” triplexes.

Because

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