1
|
Yao D, Gong X, Ma Y, Gong T, Wang G. The prevalence and interventions of xerosis cutis among older adults: A systematic review and meta-analysis. Geriatr Nurs 2023; 54:219-228. [PMID: 37844538 DOI: 10.1016/j.gerinurse.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Xerosis cutis in older adults is a geriatric public health issue that severely affects healthy aging, associated with adverse outcomes and increased nursing burden. Skin care plays a significant role in the management of xerosis cutis. AIM To assess the pooled prevalence and interventions of xerosis cutis among older adults. METHODS We searched ten databases systematically from inception to August 29, 2023. We estimated pooled prevalence of xerosis cutis using Stata 15.0. RESULTS 28 articles were included in this review. The pooled prevalence of xerosis cutis was 53 %(95 %CI:36-69 %). We found the prevalence of xerosis cutis was highest in nursing homes and developed countries. The prevalence of xerosis cutis was similar in males and females. The prevalence of mild xerosis cutis and xerosis cutis at lower limbs was relatively high. Regular use of humectant-containing leave-on skin care products and structured skin care regimens were helpful in alleviating xerosis cutis. CONCLUSION Older adults are at high risk for xerosis cutis. The research provides health professionals with a basic framework for the prevention and management of xerosis cutis.
Collapse
Affiliation(s)
- Dan Yao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China
| | - Xiaoyan Gong
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China
| | - Yao Ma
- School of Medicine, University of Electronic Science and Technology of China, No.4, Section 2, Jianshe north Road, Chenghua District, Chengdu City, Sichuan province 610054, China
| | - Ting Gong
- Department of Nursing, Chengdu second people's hospital, No. 10, Qingyun South Street, Jinjiang District, Chengdu City, Sichuan province 610017, China
| | - Guorong Wang
- Department of Nursing, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Cancer Hospital affiliate to University of Electronic Science and Technology of China, No. 55, Section 4, Renmin south Road, Wuhou District, Chengdu City, Sichuan province 610042, China.
| |
Collapse
|
2
|
Liu W, Cai J, Sun C, Zou Z, Zhang J, Huang C. Time-trends for eczema prevalences among children and adults from 1985 to 2015 in China: a systematic review. BMC Public Health 2022; 22:1294. [PMID: 35790959 PMCID: PMC9254617 DOI: 10.1186/s12889-022-13650-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/06/2022] [Indexed: 04/11/2023] Open
Abstract
Abstract
Background
Several studies have reported that childhood prevalence of eczema has been increasing worldwide. However, none study quantitatively evaluated prevalence trends of eczema among children and adults in the last 30 years in China.
Methods and Findings
Via a systematic review of literature databases in English and Chinese, we summarized all studies reporting eczema prevalences from 1985 to 2015 in China as well as diagramed prevalence and eczematous population trends against year for different age groups. A total of 93 studies and 17 studies (16 for children and one for adults) were selected for qualitative and quantitative synthesis, respectively. Childhood lifetime-ever eczema prevalences ranged from 10.0% to 30.0%. Prevalences among 3-12-year-olds children showed increasing trends in most specific cities, but national lifetime-ever eczema prevalences among 13-14-year-olds children decreased from 10.6% in 2001 to 8.6% in 2009 in mainland China. We estimated that about 1.5 million children aged 13-14-year-olds in 2009 and 15.5 million children aged 3-6-year-olds in 2012 had lifetime-ever eczema in mainland China. Similar studies were too few to ascertain time-trends of eczema prevalence among adults. About 39.4, 20.0, and 11.6 million adults aged 15-86-year-olds in 2010 had contact dermatitis, seborrheic dermatitis, and atopic dermatitis in the mainland China, respectively.
Conclusions
The burden of eczema became heavier in young children, whereas perhaps had been reduced in adolescent in China. More studies for eczema prevalence in adults are warranted.
Collapse
|
3
|
Mahdavi Nejad T, Mohammadi F, Gorgulu O, Motalebi SA, Hosseinkhani Z. Validation of the Persian version of Skindex-16 among older patients with skin diseases. BMC Geriatr 2021; 21:724. [PMID: 34922470 PMCID: PMC8684253 DOI: 10.1186/s12877-021-02635-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background Skin conditions often considerably impact the older patients’ psycho-social health and quality of life (QoL). The present study was aimed to examine the validity and reliability of the Persian version of Skindex-16 among older people with skin diseases. Methods In this validation study, 260 older patients suffering from a range of skin conditions were recruited from a dermatology clinic in Rasht, Iran. Data were collected using a checklist for demographic and clinical characteristics and the Skindex-16 questionnaire. In this study, validity (face, content, and construct) and reliability (Cronbach’s alpha) of the Skindex-16 were assessed and reported. Results The mean age of participants was 64.51 ± 5.04 years. The results of confirmatory factor analysis showed that the model had acceptable fitness into the expected three-factor structure [χ 2 /df = 249.363, P < 0.001; GFI = 0.961; TLI =0.952; RMSEA = 0.078 (90% CI = 0.06, 0.09) and SRMR = 0.06]. The reliability analysis results confirmed that the values of Cronbach’s alpha coefficient for Skindex-16 were in the acceptable range (0.923). Conclusions Our evaluation of the Skindex-16 indicates that it is reliable and a valid instrument that can be used for measuring QoL for Iranian dermatologic patients.
Collapse
Affiliation(s)
- Tahereh Mahdavi Nejad
- Student Research Committee, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Mohammadi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ozkan Gorgulu
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey
| | - Seyedeh Ameneh Motalebi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| |
Collapse
|
4
|
Skin Diseases among the Old Age Residents in a Nursing Home: A Neglected Problem. Dermatol Res Pract 2020; 2020:8849355. [PMID: 33204253 PMCID: PMC7661112 DOI: 10.1155/2020/8849355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/21/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
Background Geriatric health care has become a worldwide concern, but a few statistical studies were carried out about skin diseases in this age group in the nursing home of Iran. Aims In this study, we set out to determine the frequency as well as the age and gender distribution of dermatological diseases in nursing home old age residents. Methods In a cross-sectional study, all patients over 60 years who were living in a charity nursing home complex of Rasht in 2017 participated in this study. Baseline information on sociodemographic variables, past medical history, and medication were gathered by medical staff during a face-to-face interview. Full-body skin examination was done by dermatologists. Biopsy, and pathological and laboratory methods were used to confirm the diagnosis of suspected lesions or disease. Results In this study, 259 people underwent the study. 52.9% were male, and their mean age was 73.5 years (SD = 9.1 years). Hypertension (20.9%); diabetes mellitus (9.7%), and hypothyroidism (2.3%) were the most common underlying diseases. Most of them (85.7%) had age-related skin changes. The benign neoplasm was the most common skin disease among patients (68.3%), followed by infectious diseases (46.3%) and erythemo-squamous (31.6%). None of them had precancerous lesions or skin cancers. There were not any differences between skin disorders and gender or age groups in this study. Conclusion Our study suggests that skin manifestations and diseases are common among nursing home old age residents in this area. Therefore, this should constitute one of the top priorities of aged care physicians and nurses.
Collapse
|
5
|
Tourlaki A, Genovese G, Consonni D, Brambilla L. Efficacy of a detergent combined with a moisturizer for the treatment of pruritus associated with xerosis in an elderly population affected by Kaposi's sarcoma. GIORN ITAL DERMAT V 2020; 155:487-491. [DOI: 10.23736/s0392-0488.18.05765-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
6
|
Yong SS, Kwan Z, Ch'ng CC, Yong ASW, Tan LL, Han WH, Kamaruzzaman SB, Chin AV, Tan MP. Self-reported generalised pruritus among community-dwelling older adults in Malaysia. BMC Geriatr 2020; 20:223. [PMID: 32580764 PMCID: PMC7315470 DOI: 10.1186/s12877-020-01610-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 06/10/2020] [Indexed: 11/11/2022] Open
Abstract
Background The ageing skin is more susceptible to pruritic dermatoses, which are associated with adverse psychosocial effects and reduced quality of life among older adults. This cross-sectional study aimed to identify the burden of pruritus and factors associated with its presence and severity among older adults recruited to the Malaysian Elders Longitudinal Research study. Methods Seven hundred seventy individuals aged 55 years (lower age limit) and above were interviewed as to whether they experienced pruritus during the preceding week and the locations involved if present. The association between generalised pruritus, sleep quality, and major systemic risk factors were explored. Results 5.97% of respondents reported generalised pruritus. Generalised pruritus was associated with poorer sleep quality, with Pittsburgh Sleep Quality Index score above 6. Mean haemoglobin level was lower in subjects with generalised pruritus (13.14 g/dL) but there was no significant difference in the frequency of generalised pruritus and severe generalized pruritus between subjects with clinically defined anaemia. Also, there were no significant associations between other major systemic risk factors and generalised pruritus in this population-based study. There was no association between generalised pruritus with depression, anxiety or stress. Conclusion The negative effect of pruritus on sleep quality suggests a possible deleterious effect of pruritus on health and quality of life. Further prospective research on the longer-term effects of pruritus on health status is now warranted. (222 words)
Collapse
Affiliation(s)
- Shin Shen Yong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Zhenli Kwan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chin Chwen Ch'ng
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Adrian Sze Wai Yong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Leng Leng Tan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Winn Hui Han
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ai-Vyrn Chin
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
7
|
Forner C, Zeidler C, Stein P, Stössel E, Wefelmeier L, Peukert N, Isermann D, Ständer S. Woad extract containing cream improves significantly dry, irritated, and pruritic skin. Dermatol Ther 2019; 32:e12939. [PMID: 30990240 DOI: 10.1111/dth.12939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 04/13/2019] [Indexed: 01/30/2023]
Abstract
Objective of this open, noninterventional, noncontrolled study was to investigate the tolerability and performance of a woad extract containing cream in subjects with dry, pruritic skin after twice daily application over 2 weeks. Assessments included sensorial characteristics, skin condition, pruritus (numeric rating scale [NRS], dynamic pruritus score [DPS]), skin dryness (itch-controlled days [ItchCD], overall dry skin [ODS]), transepidermal water loss (TEWL), skin hydration and quality of life (5PLQ, DLQI). All sensorial characteristics were well perceived (>4), with tolerability (4.77 ± 0.47) and no negative skin feelings (4.73 ± 0.74) achieving the highest scores (0-5 scale). Dry skin and symptoms improved significantly (p < .001) for all variables: NRS (from 4.8 ± 1.74 to 1.83 ± 2.18), ItchCD (from 8.23 ± 4.40 to 4.81 ± 4.07), ODS (from 1.80 ± 0.85 to 0.65 ± 0.65), hydration (23.33 ± 1.33 to 40.70 ± 1.86), and quality of life (5PLQ: from 7.12 ± 4.25 to 4.24 ± 3.67; DLQI: from 5.29 ± 4.79 to 3.00 ± 3.98). The DPS revealed a moderate antipruritic effect. The TEWL decreased slightly (p = .511). No side effects were reported. The study suggests that, the cream is effective, and well tolerated in treating dry, irritated, and pruritic skin.
Collapse
Affiliation(s)
- Caroline Forner
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - Claudia Zeidler
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | | | | | | | - Nadine Peukert
- Aestheso Aesthetic and Laser Treatments, Münster, Germany
| | | | - Sonja Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| |
Collapse
|
8
|
Yaldiz M. Dermatological diseases in the geriatric age group: Retrospective analysis of 7092 patients. Geriatr Gerontol Int 2019; 19:582-585. [PMID: 30950155 DOI: 10.1111/ggi.13665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/05/2019] [Accepted: 03/08/2019] [Indexed: 11/29/2022]
Abstract
AIM The aim of the present study was to retrospectively investigate the dermatological diseases seen in geriatric patients, and their distribution according to age, sex and season, making a significant contribution to the few previous prevalence studies. METHODS Data from 7092 geriatric patients examined at our dermatology clinic from 1 January to 31 December 2017 were retrospectively analyzed. The data were analyzed according to age, sex and seasons. RESULTS The seven most frequently occurring diseases were eczematous dermatitis, fungal infections, pruritus, precancerous and malignant neoplasm, xerosis cutis, benign neoplasms, and papulosquamous diseases, respectively. In the youngest group, the most frequent disease was eczematous dermatitis, whereas in the older group it was precancerous and malignant neoplasms. The most common disease for both men and women was eczematous dermatitis. Eczematous dermatitis, pruritus, xerosis cutis, rash and general drug eruptions, and papulosquamous diseases were most frequent in the winter, but less in the summer (P < 0.01). Fungal diseases were frequent in the spring and summer (P < 0.01). Pigmentation disorders were frequent in the summer (P < 0.01). CONCLUSIONS The present study, which is the largest prevalence study in the literature with 7092 geriatric patients, will raise awareness regarding the pattern and nature of dermatological diseases in geriatric patients. Geriatr Gerontol Int 2019; 19: 582-585.
Collapse
Affiliation(s)
- Mahizer Yaldiz
- Department of Dermatology, Sakarya Training and Research Hospital, Sakarya, Turkey
| |
Collapse
|
9
|
Lichterfeld-Kottner A, Lahmann N, Blume-Peytavi U, Mueller-Werdan U, Kottner J. Dry skin in home care: A representative prevalence study. J Tissue Viability 2018; 27:226-231. [DOI: 10.1016/j.jtv.2018.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/30/2018] [Accepted: 07/01/2018] [Indexed: 10/28/2022]
|
10
|
Katoh N, Tennstedt D, Abellan van Kan G, Saint Aroman M, Loir A, Bacqueville D, Duprat L, Guiraud B, Bessou-Touya S, Duplan H. Gerontodermatology: the fragility of the epidermis in older adults. J Eur Acad Dermatol Venereol 2018; 32 Suppl 4:1-20. [DOI: 10.1111/jdv.15253] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/18/2018] [Indexed: 12/15/2022]
Affiliation(s)
- N. Katoh
- Department of Dermatology; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - D. Tennstedt
- Department of Dermatology; Saint-Luc University Clinics; Brussels Belgium
| | - G. Abellan van Kan
- Gérontopôle; Department of Internal Medicine and Geriatrics; Toulouse University Hospital; Toulouse France
| | | | - A. Loir
- Pierre Fabre Dermo-Cosmétique; Lavaur France
| | - D. Bacqueville
- Pharmacology Division; Pierre Fabre Dermo-Cosmétique; Toulouse France
| | - L. Duprat
- Pharmacology Division; Pierre Fabre Dermo-Cosmétique; Toulouse France
| | - B. Guiraud
- Pharmacology Division; Pierre Fabre Dermo-Cosmétique; Toulouse France
| | - S. Bessou-Touya
- Pharmacology Division; Pierre Fabre Dermo-Cosmétique; Toulouse France
| | - H. Duplan
- Pharmacology Division; Pierre Fabre Dermo-Cosmétique; Toulouse France
| |
Collapse
|
11
|
Lin CY, Chang FW, Yang JJ, Chang CH, Yeh CL, Lei WT, Huang CF, Liu JM, Hsu RJ. Increased risk of bipolar disorder in patients with scabies: A nationwide population-based matched-cohort study. Psychiatry Res 2017; 257:14-20. [PMID: 28709117 DOI: 10.1016/j.psychres.2017.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 06/17/2017] [Accepted: 07/04/2017] [Indexed: 02/09/2023]
Abstract
Both scabies and bipolar disorder (BD) are common and troublesome disorders. There are several similarities in both diseases: pruritus, a higher prevalence in crowded environments, and cytokine-mediated inflammatory processes in the pathophysiology. We conducted this nationwide population-based study to investigate the possible relationship between scabies and BD. Based on the National Health Insurance Research Database (NHIRD) of Taiwan, a total of 7096 patients with scabies were identified as a study group and 28,375 matched patients as a control. We tracked the patients in both groups for a 7-year period to identify those newly diagnosed with BD. The demographic characteristics and comorbidities of the patients were analyzed, and Cox proportional hazard regressions were performed to calculate the hazard ratio (HR) of BD. Of the 35,471 patients in this study, 183 (0.5%) patients with newly diagnosed BD were identified, with 58 (0.8%) from the scabies group and 125 (0.4%) from the control group. The patients with scabies had a higher risk of subsequent BD, with a crude hazard ratio of 1.86 and an adjusted hazard ratio of 1.55 (95% confidence interval: 1.12-2.09, P < 0.05). This study shows there is an increased risk for BD among patients with scabies. Immunopathology may contribute to this association.
Collapse
Affiliation(s)
- Chien-Yu Lin
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan; Division of Infection and Pathway Medicine, College of Medicine and Veterinary Medicine, the University of Edinburgh, Scotland, UK.
| | - Fung-Wei Chang
- Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| | - Jing-Jung Yang
- Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan; Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
| | - Chun-Hung Chang
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; Institute of Clinical Medicine, China Medical University, Taichung, Taiwan.
| | - Chia-Lun Yeh
- Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
| | - Wei-Te Lei
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.
| | - Chun-Fa Huang
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Nursing, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Jui-Ming Liu
- Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; Department of Medicine, National Yang-Ming University, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Ren-Jun Hsu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; Biobank Management Center of the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Pathology and Graduate Institute of Pathology and Parasitology, the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| |
Collapse
|
12
|
Abstract
OBJECTIVE This study aimed to investigate skin hydration status of the lower legs by comparing several methods and examining lifestyle-related factors in community-dwelling older people. METHODS A cross-sectional study was conducted in three community settings in Japan from autumn to winter. Participants were older people aged ≥65 years (n=118). Skin hydration status of the lower legs was evaluated by stratum corneum hydration using an electrical device, clinical symptoms by an expert's observation and the visual analogue scale. Lifestyle factors of skin care were evaluated by a self-administered questionnaire. RESULTS The mean age of participants was 74.4 years and 83.9% were women. Stratum corneum hydration was significantly correlated with clinical scores by an expert's observation (rho=-0.46, P<0.001), but it was not correlated with the visual analogue scale (rho=-0.08, P=0.435). Among participants who did not perceive dry skin, 57.5% showed low stratum corneum hydration. Hospitalization in the past year (b=-9.4, P=0.008), excessive bathing habits (b=-4.6, P=0.014), and having an outdoor hobby (b=-5.7, P=0.007) were negatively associated, and diuretics (b=11.5, P=0.002) and lotion-type moisturizer use (b=4.6, P=0.022) were positively associated with stratum corneum hydration. CONCLUSION Stratum corneum hydration measurements show an adequate association with observation-based evaluation by an expert, but poor agreement with subjective evaluation in community-dwelling older people. Hospitalization experience and lifestyle factors are associated with skin hydration.
Collapse
Affiliation(s)
- Shinji Iizaka
- School of Nutrition, College of Nursing and Nutrition, Shukutoku University, 673 Nitonacho, Chuo-ku, Chiba-shi, Chiba, 260-8703, Japan.
| |
Collapse
|
13
|
Blume-Peytavi U, Kottner J, Sterry W, Hodin MW, Griffiths TW, Watson REB, Hay RJ, Griffiths CEM. Age-Associated Skin Conditions and Diseases: Current Perspectives and Future Options. THE GERONTOLOGIST 2017; 56 Suppl 2:S230-42. [PMID: 26994263 DOI: 10.1093/geront/gnw003] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The International League of Dermatological Societies (ILDS), a global, not-for-profit organization representing 157 dermatological societies worldwide, has identified the consequences of skin aging as one of the most important grand challenges in global skin health. Reduced functional capacity and increased susceptibility of the skin with development of dermatoses such as dry skin, itching, ulcers, dyspigmentation, wrinkles, fungal infections, as well as benign and malignant tumors are the most common skin conditions in aged populations worldwide. Environmental (e.g., pollution) and lifestyle factors (e.g., smoking, sunbed use) negatively affect skin health. In turn altered appearance, dry skin, chronic wounds, and other conditions decrease general health and reduce the likelihood for healthy and active aging. Preventive skin care includes primary, secondary, and tertiary interventions. Continuous sun protection from early childhood onward is most important, to avoid extrinsic skin damage and skin cancer. Exposure to irritants, allergens, or other molecules damaging the skin must be avoided or reduced to a minimum. Public health approaches are needed to implement preventive and basic skin care worldwide to reach high numbers of dermatological patients and care receivers. Education of primary caregivers and implementation of community dermatology are successful strategies in resource-poor countries. Besides specialist physicians, nurses and other health care professionals play important roles in preventing and managing age-related skin conditions in developing as well as in developed countries. Healthy skin across the life course leads to better mental and emotional health, positive impact on social engagement, and healthier, more active, and productive lives.
Collapse
Affiliation(s)
- Ulrike Blume-Peytavi
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Germany.
| | - Jan Kottner
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Germany
| | - Wolfram Sterry
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Germany. The International League of Dermatological Societies, London, UK
| | | | - Tamara W Griffiths
- The Dermatology Centre, University of Manchester, Academic Health Science Centre, UK
| | - Rachel E B Watson
- The Dermatology Centre, University of Manchester, Academic Health Science Centre, UK
| | | | - Christopher E M Griffiths
- The Dermatology Centre, University of Manchester, Academic Health Science Centre, UK. The International League of Dermatological Societies, London, UK
| |
Collapse
|
14
|
Iizaka S, Nagata S, Sanada H. Nutritional Status and Habitual Dietary Intake Are Associated with Frail Skin Conditions in Community-Dwelling Older People. J Nutr Health Aging 2017; 21:137-146. [PMID: 28112767 DOI: 10.1007/s12603-016-0736-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Prevention of frail skin is important in older people because frail skin is associated with a risk of injury in this population. In this study, we investigated the association of nutritional status and habitual dietary intake with skin conditions in community-dwelling older people. DESIGN Cross-sectional study. SETTING Three community settings in Japan from autumn to winter. PARTICIPANTS Older people aged ≥65 years without care-need certification (n=118). MEASUREMENTS Malnutrition and obesity were evaluated to assess the nutritional status. Nutrient and food group intakes per 1000 kcal were evaluated using a brief self-administered diet history questionnaire. Dietary patterns based on food groups were evaluated by principal component analysis. Skin condition parameters, including stratum corneum hydration, appearance of xerosis (specific symptom sum score [SRRC score]), and dermal intensity by high-frequency ultrasonography, were measured on a lower leg. Multiple linear regression analysis was performed with adjustment for confounders. RESULTS The mean (standard deviation) age was 74.1 (4.8) years, and 83.1% of participants were female. A higher intake of plant fat (p=0.018) was associated with a lower SRRC score. Higher intakes of α-tocopherol (p=0.050) and vitamin C (p=0.017) were associated with increased dermal intensity. A body mass index ≥25 (p=0.016) was associated with decreased dermal intensity. A dietary pattern characterized by higher vegetable and fruit intake was associated with a better skin condition. CONCLUSION Plant fat, antioxidant vitamins, and a dietary pattern characterized by vegetables and fruits showed positive and obesity showed negative associations for frail skin in community-dwelling older people.
Collapse
Affiliation(s)
- S Iizaka
- Shinji Iizaka, RN, PhD, School of Nutrition, College of Nursing and Nutrition, Shukutoku University. 673 Nitonacho, Chuo-ku, Chiba-shi, Chiba, Japan Phone:81-43-305-1881 E-mail:
| | | | | |
Collapse
|
15
|
Norman RA, Walsh M, Naylor M. Overview and Update in Geriatric Dermatology. CURRENT GERIATRICS REPORTS 2016. [DOI: 10.1007/s13670-016-0191-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
16
|
Lichterfeld A, Lahmann N, Blume-Peytavi U, Kottner J. Dry skin in nursing care receivers: A multi-centre cross-sectional prevalence study in hospitals and nursing homes. Int J Nurs Stud 2016; 56:37-44. [DOI: 10.1016/j.ijnurstu.2016.01.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 01/24/2023]
|
17
|
Jindal R, Jain A, Roy S, Rawat SDS, Bhardwaj N. Skin Disorders Among Geriatric Population at a Tertiary Care Center in Uttarakhand. J Clin Diagn Res 2016; 10:WC06-8. [PMID: 27134982 DOI: 10.7860/jcdr/2016/17015.7500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/02/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Ageing results in decline of normal functioning in all organ systems including skin. This predisposes the elderly persons to develop various skin ailments. A thorough knowledge of different diseases prevalent in this population in different geographic regions help the health care providers in better health care policy making. AIM This study was planned to know the common dermatological diseases prevalent in Uttarakhand region of India. MATERIALS AND METHODS Hospital out patients records maintained in Department of Dermatology, Venereology & Leprosy were analysed and information regarding age, sex and diagnosis of patients were recorded. Descriptive statistics for prevalence of skin diseases in patients presenting to hospital were calculated. RESULTS Out of the total 29,422 patients seen in dermatology department from August 2012 to 2014, 4.7% (1,380) were aged 60 years and above. Male to female ratio was 2:1. Erythemato-squamous disorders taken collectively constituted the major skin disorder seen in 38.9% patients. This was followed by infections and infestations (29.9%), senile pruritus (9.0%) and age related skin changes (3.7%). Benign neoplasms were seen in 1.1% patients followed by cutaneous malignancies in 0.8% and precancerous lesions in 0.4%. Fungal infections were the most common infections seen in 18% patients. CONCLUSION This study strengthens the opinion that infections, senile pruritus and eczema-dermatitis are the major dermatological disorders in elderly population.
Collapse
Affiliation(s)
- Rashmi Jindal
- Assistant Professor, Department of Dermatology, Venereology & Leprosy, Himalayan Institute of Medical Sciences , Swami Ram Nagar, Dehradun, India
| | - Akanksha Jain
- Assistant Professor, Department of Dermatology, Venereology & Leprosy, Himalayan Institute of Medical Sciences , Swami Ram Nagar, Dehradun, India
| | - Samarjit Roy
- Associate Professor, Department of Dermatology, Venereology & Leprosy, Himalayan Institute of Medical Sciences , Swami Ram Nagar, Dehradun, India
| | - S D S Rawat
- Professor, Department of Dermatology, Venereology & Leprosy, Himalayan Institute of Medical Sciences , Swami Ram Nagar, Dehradun, India
| | - Nancy Bhardwaj
- Post Graduate Student, Department of Dermatology, Venereology & Leprosy, Himalayan Institute of Medical Sciences , Swami Ram Nagar, Dehradun, India
| |
Collapse
|
18
|
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:e009941. [PMID: 26700288 PMCID: PMC4691723 DOI: 10.1136/bmjopen-2015-009941] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To estimate the prevalence of dermatological disease in aged care facilities, and the relationship between cognitive or physical disability and significant disease. SETTING 2 large aged care facilities in Auckland, New Zealand, each providing low and high level care. PARTICIPANTS All 161 residents of the facilities were invited to participate. The only exclusion criterion was inability to obtain consent from the individual or designated guardian. 88 participants were recruited-66 females (75%), 22 males (25%) with average age 87.1 years (SD 5.5 years). PRIMARY AND SECONDARY OUTCOME MEASURES Primary--presence of significant skin disease (defined as that which in the opinion of the investigators needed treatment or was identified as a patient concern) diagnosed clinically on full dermatological examination by a dermatologist or dermatology trainee. Secondary--functional and cognitive status (Rehabilitation Complexity Scale and Abbreviated Mental Test Score). RESULTS 81.8% were found to have at least one significant condition. The most common disorders were onychomycosis 42 (47.7%), basal cell carcinoma 13 (14.8%), asteototic eczema 11 (12.5%) and squamous cell carcinoma in situ 9 (10.2%). Other findings were invasive squamous cell carcinoma 7 (8%), bullous pemphigoid 2 (2.3%), melanoma 2 (2.3%), lichen sclerosus 2 (2.3%) and carcinoma of the breast 1 (1.1%). Inflammatory disease was more common in those with little physical disability compared with those with serious physical disability (OR 3.69; 95% CI 1.1 to 12.6, p=0.04). No significant association was found between skin disease and cognitive impairment. CONCLUSIONS A high rate of dermatological disease was found. Findings ranged from frequent but not life-threatening conditions (eg, onychomycosis), to those associated with a significant morbidity (eg, eczema, lichen sclerosus and bullous pemphigoid), to potentially life-threatening (eg, squamous cell carcinoma, melanoma and breast cancer). Those with less significant physical impairment were found to be at greater risk of inflammatory dermatoses.
Collapse
Affiliation(s)
- Maneka S Deo
- Department of Dermatology, Middlemore Hospital, Auckland, New Zealand
| | - Ngaire Kerse
- Faculty of Medical and Health Sciences, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alain C Vandal
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand and Ko Awatea, Counties Manukau District Health Board, Auckland, New Zealand
| | - Paul Jarrett
- Department of Dermatology, Middlemore Hospital, Auckland, New Zealand
- Department of Medicine, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
19
|
|
20
|
Reszke R, Pełka D, Walasek A, Machaj Z, Reich A. Skin disorders in elderly subjects. Int J Dermatol 2015; 54:e332-8. [DOI: 10.1111/ijd.12832] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 07/22/2014] [Accepted: 07/26/2014] [Indexed: 02/02/2023]
Affiliation(s)
- Radomir Reszke
- Department of Dermatology, Venereology and Allergology; Wroclaw Medical University; Wroclaw Poland
| | - Dorota Pełka
- Department of Dermatology, Venereology and Allergology; Wroclaw Medical University; Wroclaw Poland
| | - Angela Walasek
- Department of Dermatology, Venereology and Allergology; Wroclaw Medical University; Wroclaw Poland
| | - Zbigniew Machaj
- Department of Internal Diseases, Geriatrics and Allergology; Wroclaw Medical University; Wroclaw Poland
| | - Adam Reich
- Department of Dermatology, Venereology and Allergology; Wroclaw Medical University; Wroclaw Poland
| |
Collapse
|
21
|
Al-Nuaimi Y, Sherratt MJ, Griffiths CEM. Skin health in older age. Maturitas 2014; 79:256-64. [PMID: 25213594 DOI: 10.1016/j.maturitas.2014.08.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 08/08/2014] [Indexed: 01/09/2023]
Abstract
As people age, their skin undergoes changes which result in reduced elasticity, increased fragility and an altered immune response; in essence it becomes frail. As life expectancy is increasing the health of older skin is becoming a progressively more important facet of overall care. In addition to the consequences of ageing for otherwise healthy skin, the relative incidence of some dermatological conditions is age-dependent. In particular, xerosis (dry skin), cutaneous malignancies and skin injuries are more common in older people. In this review we describe the functional consequences of skin ageing and discuss the current evidence on how skin health may be maintained and dermatological conditions prevented in an ageing population. The future of dermatological health-care provision in the older population relies on the development of coordinated pathways of care, which start from a young age. Better quality research coordinated by the establishment of institutions dealing with skin health and ageing would be a method of addressing these needs.
Collapse
Affiliation(s)
- Yusur Al-Nuaimi
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; The Dermatology Centre, Barnes Building, Salford Royal NHS Foundation Trust M6 8HD, UK.
| | - Michael J Sherratt
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; School of Biomedicine, The University of Manchester, Manchester M13 9PT, UK
| | - Christopher E M Griffiths
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; The Dermatology Centre, Barnes Building, Salford Royal NHS Foundation Trust M6 8HD, UK
| |
Collapse
|
22
|
Wu BY, Wu BJ, Lee SM, Sun HJ, Chang YT, Lin MW. Prevalence and associated factors of comorbid skin diseases in patients with schizophrenia: a clinical survey and national health database study. Gen Hosp Psychiatry 2014; 36:415-21. [PMID: 24703505 DOI: 10.1016/j.genhosppsych.2014.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 02/09/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To examine the epidemiology of and possible risk factors for skin diseases in patients with schizophrenia. METHODS All of 337 patients with schizophrenia were recruited from the therapeutic community of a psychiatric hospital and underwent a detailed skin examination. The National Health Insurance Research Database (NHIRD) was used to compare the prevalence of skin diseases between patients with schizophrenia and those without. RESULTS In the clinical survey, fungal infection (61.4%) and dermatitis (46.9%) were the most common skin diseases. Clozapine users had a lower risk of fungal infection than those on typical antipsychotics [odds ratio (OR)=0.49, 95% confidence interval (CI)=0.30-0.81]. Obese patients were more likely to have fungal infections than those without (OR=1.93, 95% CI=1.20-3.09), and those with diabetes had an increased risk of bacterial infection than those without (OR=2.0, 95% CI=1.06-3.75). NHIRD revealed that the overall prevalence of skin diseases, including infections, dermatitis, hyperkeratosis, pilosebaceous disease, androgenic alopecia, xerosis and stasis, were higher in patients with schizophrenia than in those without (75.1% vs. 72.6%, P=.01). CONCLUSIONS The prevalence of skin diseases is high in patients with schizophrenia, for whom proper skin care is necessary to improve their life quality.
Collapse
Affiliation(s)
- Bai-Yao Wu
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan (R.O.C.); Division of Preventive Medicine, Institute of Public Health, National Yang-Ming University, Taipei 112, Taiwan (R.O.C.)
| | - Bo-Jian Wu
- Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien 981, Taiwan (R.O.C.)
| | - Shin-Min Lee
- Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien 981, Taiwan (R.O.C.); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan (R.O.C.)
| | - Hsiao-Ju Sun
- Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien 981, Taiwan (R.O.C.)
| | - Yun-Ting Chang
- Department of Dermatology, Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan (R.O.C.); Department of Dermatology, Taipei Veterans General Hospital, Taipei 112, Taiwan (R.O.C.)
| | - Ming-Wei Lin
- Division of Preventive Medicine, Institute of Public Health, National Yang-Ming University, Taipei 112, Taiwan (R.O.C.).
| |
Collapse
|
23
|
Kemp J, Després O, Pebayle T, Dufour A. Age-related decrease in sensitivity to electrical stimulation is unrelated to skin conductance: An evoked potentials study. Clin Neurophysiol 2014; 125:602-7. [DOI: 10.1016/j.clinph.2013.08.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/11/2013] [Accepted: 08/15/2013] [Indexed: 10/26/2022]
|
24
|
Nakagami G, Kimura N, Takehara K, Nakamura T, Kawashima M, Tsunemi Y, Sanada H. Relationship between activity of daily living and asteatosis in the lower legs among elderly residents in long-term care institutions: a cross-sectional study. Int Wound J 2013; 12:586-9. [PMID: 24131671 DOI: 10.1111/iwj.12169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/01/2013] [Accepted: 09/11/2013] [Indexed: 11/29/2022] Open
Abstract
This cross-sectional observational study investigated the relationship between the level of activities of daily living (ADL) and asteatosis in the lower legs among elderly residents. We enrolled 173 residents from a long-term care health facility and two special nursing homes for elderly persons in the Tokyo metropolitan area and Oshima Island, Japan. The level of ADL was measured by the Barthel Index. The relationship between the Barthel Index total score and the presence of asteatosis in the lower legs diagnosed by a dermatologist was analysed by multivariate logistic regression analysis. Among the residents, 79·2% had asteatosis in their lower legs. An increase of 1 point in the Barthel Index total score was significantly associated with a decreased probability of lower leg asteatosis after adjusting for age, sex and the type of institution (adjusted odds ratio = 0·982; 95% confidence interval: 0·966-0·998). A higher level of ADL is associated with a lower probability of having asteatosis in the lower legs among residents in long-term care institutions. Nurses should pay specific attention to residents with limited ADL for initiating preventive care for asteatosis.
Collapse
Affiliation(s)
- Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nao Kimura
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kimie Takehara
- Department of Nursing Administration, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Makoto Kawashima
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuichiro Tsunemi
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
25
|
Chang ALS, Wong JW, Endo JO, Norman RA. Geriatric Dermatology Review: Major Changes in Skin Function in Older Patients and Their Contribution to Common Clinical Challenges. J Am Med Dir Assoc 2013; 14:724-30. [DOI: 10.1016/j.jamda.2013.02.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 02/20/2013] [Accepted: 02/22/2013] [Indexed: 11/26/2022]
|
26
|
Kimura N, Nakagami G, Takehara K, Miura Y, Nakamura T, Kawashima M, Tsunemi Y, Sanada H. Prevalence of asteatosis and asteatotic eczema among elderly residents in facilities covered by long-term care insurance. J Dermatol 2013; 40:770-1. [PMID: 23855654 DOI: 10.1111/1346-8138.12217] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Nao Kimura
- Department of Gerontological Nursing/Wound Care Management, The University of Tokyo, Tokyo, Japan
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Skin Disorders among Elder Patients in a Referral Center in Northern Iran (2011). Dermatol Res Pract 2013; 2013:193205. [PMID: 23935606 PMCID: PMC3722782 DOI: 10.1155/2013/193205] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 06/03/2013] [Accepted: 06/06/2013] [Indexed: 11/18/2022] Open
Abstract
Background. Geriatric health care has become a worldwide concern, but a few statistical studies were carried out about skin diseases in this age group. In this study, we set out to determine the frequency as well as the age and gender distribution of dermatological diseases in geriatric patients. Materials and Methods. In a cross-sectional study, all patients over 60 years who were accepted to department of dermatology in north of Iran participated in this study. Baseline information and clinical examination were done by a group of dermatologists. Biopsy, Pathological and laboratory methods were used in order to confirm the diagnosis. Results. 440 patients were accepted to the department that 232 patients were male (52.7%). Benign neoplasm was as the common skin disease among patients (65%), followed by erythemo-squamous (35.3%) and precancerous lesions (26.1%). The most common precancerous lesion was actinic keratosis (24.3%). BCC by 8.8% was the most prevalent skin carcinoma. Pruritus was the common problem in other dermatological disease (22%). Conclusion. Skin disorders especially precancerous lesion are among those important health problems in elderly patients in this geographic area. Increasing general awareness about risk factors of these diseases and doing more researches in other regions are highly recommended.
Collapse
|
28
|
Lay CJ, Wang CL, Chuang HY, Chen YL, Chen HL, Tsai SJ, Tsai CC. Risk factors for delayed diagnosis of scabies in hospitalized patients from long-term care facilities. J Clin Med Res 2011; 3:72-7. [PMID: 21811533 PMCID: PMC3140926 DOI: 10.4021/jocmr520w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2011] [Indexed: 12/02/2022] Open
Abstract
Background Delayed diagnosis of scabies can cause an institutional outbreak, which causes considerably economic burden to control. This study was to find the risk factors for delayed diagnosis of scabies in hospitalized patients from long-term care facilities. Methods We conducted a retrospective analysis of the hospitalized patients from long-term care facilities, diagnosed to have scabies between January 2006 and December 2008. A stepwise logistic regression analysis was performed to determine the risk factors for delayed diagnosis of scabies. Results A total of 706 episodes with scabies were identified retrospectively in 399 hospitalized patients from long-term care facilities. Of these, 44 episodes were considered as delayed diagnosis of scabies. These patients were more associated with chronic usage of steroid (73% vs. 10%, P < 0.001) and had longer duration of hospitalization than the others (30 vs. 13 days, P < 0.001). After logistic regression, steroid therapy was the risk factor of delayed diagnosis of scabies (odds ratio: 23.493). Conclusions In the patients from long-term care facilities, clinical physicians should pay more attention to those with chronic usage of steroid to avoid delayed diagnosis of scabies. Keywords Scabies; Delayed diagnosis; Risk factor; Long-term care facility
Collapse
Affiliation(s)
- Chorng-Jang Lay
- Division of Infectious Disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
| | | | | | | | | | | | | |
Collapse
|
29
|
Sun LM, Liang JA, Chang SN, Sung FC, Muo CH, Kao CH. Analysis of Parkinson's disease and subsequent cancer risk in Taiwan: a nationwide population-based cohort study. Neuroepidemiology 2011; 37:114-9. [PMID: 21986194 DOI: 10.1159/000331489] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 08/03/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients with Parkinson's disease (PD) are suggested to be at a lower risk for the development of certain cancers and at a higher risk for melanoma. The aim of this study is to evaluate the possible association between PD and malignancy in Taiwan. MATERIALS AND METHODS We used the data of the National Health Insurance System of Taiwan to assess this issue. The PD cohort contained 4,957 patients, and each patient was randomly frequency matched by age and sex with 4 people from the general population without PD. Cox's proportional hazard regression analysis was conducted to estimate the effects of PD on the cancer risk. RESULTS In patients with PD, the risk of developing overall cancer was marginally significantly lower than in subjects without PD [adjusted hazard ratio (HR) = 0.88; 95% CI = 0.78-0.99]. For individual cancers, the risks of developing colorectal and lung cancers among patients with PD were marginally significantly lower than in subjects without PD. In contrast, despite the higher HR for the development of melanoma, it did not reach statistical significance because of the relatively small sample size. CONCLUSION Our study found that Taiwanese patients with PD have a lower risk of developing colorectal and lung cancers. The findings of this study are compatible with those of prior studies from other countries.
Collapse
Affiliation(s)
- Li-Min Sun
- Department of Radiation Oncology, Zuoying Armed Forces General Hospital, Kaohsiung, Taiwan, ROC
| | | | | | | | | | | |
Collapse
|
30
|
Irritability of the skin barrier: A comparison of chronologically aged and photo-aged skin in elderly and young adults. Eur Geriatr Med 2011. [DOI: 10.1016/j.eurger.2011.05.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
31
|
|
32
|
Paul C, Maumus-Robert S, Mazereeuw-Hautier J, Guyen C, Saudez X, Schmitt A. Prevalence and Risk Factors for Xerosis in the Elderly: A Cross-Sectional Epidemiological Study in Primary Care. Dermatology 2011; 223:260-5. [DOI: 10.1159/000334631] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 10/20/2011] [Indexed: 11/19/2022] Open
|
33
|
Hong MY, Lee CC, Chuang MC, Chao SC, Tsai MC, Chi CH. Factors related to missed diagnosis of incidental scabies infestations in patients admitted through the emergency department to inpatient services. Acad Emerg Med 2010; 17:958-64. [PMID: 20836776 DOI: 10.1111/j.1553-2712.2010.00811.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Scabies is highly contagious and requires prompt diagnosis and implementation of infection control measures to prevent transmission and outbreaks. This study investigated the clinical and administrative correlates associated with missed diagnosis of scabies in an emergency department (ED). METHODS This was a retrospective study of patients with incidental scabies infestations who were admitted to a university hospital via the ED during a 4-year period. RESULTS A total of 135 inpatients were identified as having scabies; among them, 111 patients (82%) had visited the ED. Scabies were diagnosed during the ED stay in 39 of 111 patients (35%), while the diagnosis was missed in the ED in 72 patients (65%). Although no geographic clusters suggestive of nosocomial scabies transmission were registered, 160 medical workers and one hospitalized patient received prophylactic treatment due to direct skin-to-skin contact with inpatient scabies cases during the study period. Overcrowding (odds ratio [OR] = 8.4; 95% confidence interval [CI] = 1.9 to 38.0) and time constraints (OR = 8.2; 95% CI = 1.9 to 34.7) in the ED were associated with a missed diagnosis of scabies during ED stay. Patients with lower illness severity scores were at higher risk for failure to diagnose and to treat scabies prior to hospital admission (OR = 5.7; 95% CI = 1.6 to 20.9). CONCLUSIONS Missed diagnoses of scabies during ED stay may result in nosocomial spread and increase the unnecessary use of prophylactic treatments. ED overcrowding, time constraints, and less severe illness compromise ED recognition of scabies. Health care workers should be especially alert for signs of scabies infestations under these conditions.
Collapse
Affiliation(s)
- Ming-Yuan Hong
- Department of Emergency Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan
| | | | | | | | | | | |
Collapse
|
34
|
MAKIGAMI K, OHTAKI N, ISHII N, YASUMURA S. Risk factors of scabies in psychiatric and long-term care hospitals: A nationwide mail-in survey in Japan. J Dermatol 2009; 36:491-8. [DOI: 10.1111/j.1346-8138.2009.00691.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
35
|
Kiliç A, Gül U, Aslan E, Soylu S. Dermatological findings in the senior population of nursing homes in Turkey. Arch Gerontol Geriatr 2008; 47:93-8. [PMID: 17826853 DOI: 10.1016/j.archger.2007.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2007] [Revised: 06/19/2007] [Accepted: 07/10/2007] [Indexed: 11/20/2022]
Abstract
As the elderly population grows, the problems including skin diseases become more and more frequent. This study involved 300 elderly patients living in 3 nursing homes in Ankara. Their average age was 76.4 years. The average period of time they had lived in the nursing homes was 48.7 months, 25.7% of the cases were bedridden, and 274 cases (91.3%) had at least one systemic disease. Details of the past medical history and the consumed drugs were recorded. The dermatological examination of all cases was performed. Age and sex-dependence of the findings was statistically evaluated, and the risk factors for dermatological diseases were analyzed. The most frequent diseases of the elderly people were: fungal infections and xerosis, with prevalence of 49.7% and 45.3%, respectively. Dermatitis and pruritus were less prevalent (11.0% and 10.3%, respectively). Fungal infections and varicosities were detected more frequently in males, than females. The only risk factor detected for fungal infections was the male sex. We conclude that this study contributes to the identification of the health problems of elderly people, representing a growing proportion of the population in the near future.
Collapse
Affiliation(s)
- Arzu Kiliç
- Ankara Numune Education and Research Hospital, 2nd Dermatology Clinic, Ankara, Turkey.
| | | | | | | |
Collapse
|
36
|
Motifs de consultation en dermatogériatrie. Ann Dermatol Venereol 2008; 135:410-2. [DOI: 10.1016/j.annder.2007.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 12/14/2007] [Indexed: 11/15/2022]
|
37
|
Abstract
Many functional, demographic, and immunologic changes associated with aging are responsible for increasing the incidence and severity of infectious diseases in the elderly. Management is complicated by age-related organ system changes. Because many of the elderly are on multiple medications for underlying illnesses, antimicrobial therapy needs to be chosen keeping drug interactions and adverse events in mind. Common infections seen in the elderly are infections of skin and soft tissue, urinary tract, respiratory tract, and gastrointestinal tract. Organized and well-funded programs to address infectious disease issues in the elderly are the only way to improve care.
Collapse
Affiliation(s)
- Tin Han Htwe
- Division of Infectious Diseases, Southern Illinois University School of Medicine, Post Box 19636, Springfield, IL 62794-9636, USA
| | | | | | | | | |
Collapse
|
38
|
Mseddi M, Borgi N, Sellami L, Meziou TJ, Turki H, Zahaf A. [Cutaneous pathology in the elderly]. Ann Dermatol Venereol 2006; 133:272-4. [PMID: 16800182 DOI: 10.1016/s0151-9638(06)70896-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
39
|
Tuncel AA, Erbagci Z. Prevalence of skin diseases among male adolescent and post-adolescent boarding school students in Turkey. J Dermatol 2006; 32:557-64. [PMID: 16335871 DOI: 10.1111/j.1346-8138.2005.tb00798.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Skin disease is a common problem in boarding schools and may account for significant morbidity. To document the prevalence and patterns of skin diseases among male adolescent and post-adolescent boarding school residents, a cross-sectional epidemiologic survey was performed. A total of 682 students were examined for evidence of any skin disease, and subjects with skin disease(s) were also asked to fill in a questionnaire. Of the study population, 378 (55.42%) had at least one skin disease. The most prevalent diseases were tinea pedis (32.5%), acne vulgaris (28.6%), onychomycosis (8.06%), androgenetic alopecia (5.6%), common warts (5.3%), unguium incarnatus (4.1%), irritant hand dermatitis (3.6%), foot callosities (3.6%), and pitted keratolysis (2.6%). Of those with skin problem(s), 245 (65%) were not aware of their disease(s) and 45% of the remaining 133 subjects who were aware of their disease(s) had not sought medical help. We concluded that skin diseases, especially foot problems, are very common among male boarding school students. In additional to monitoring the epidemiology of skin diseases, intermittent medical education programs for both health-care workers and residents living in these communities would be useful for enhancing knowledge of available and effective treatments and implementing appropriate preventive measures.
Collapse
Affiliation(s)
- A Almila Tuncel
- Gaziantep University Medical Faculty, Department of Dermatology, Turkey
| | | |
Collapse
|