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George CD, Lee T, Hollestein LM, Asgari MM, Nijsten T. Global epidemiology of actinic keratosis in the general population: a systematic review and meta-analysis. Br J Dermatol 2024; 190:465-476. [PMID: 37890083 DOI: 10.1093/bjd/ljad371] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/11/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Actinic keratosis (AK) is a common dermatological condition, and among the most common dermatological diagnoses in older populations. Although the prevalence of AK depends on demographic and environmental factors, little is known about the global context of AK. OBJECTIVES To provide a comprehensive and updated analysis of the global prevalence rate and incidence of AK in the general population through a systematic review and meta-analysis, and - through subgroup analyses - to identify high-risk phenotypes, demographic and lifestyle risk factors and regional variations in disease prevalence. METHODS A systematic search of Embase, MEDLINE, Web of Science and Google Scholar was performed on 20 May 2022. Two reviewers independently screened and assessed the quality of each study using a validated critical appraisal checklist. Epidemiological measurements (e.g. prevalence) from individual studies performed in the general population were then pooled in a random-effects meta-analysis. Subgroup analyses (i.e. population age, geographical region, occupation, sex and study quality) were conducted. RESULTS Of the 65 articles that made it through the full-text screening, 60 reported a point prevalence. A meta-analysis of these articles yielded an overall point prevalence of 14% [95% confidence interval (CI) 14-15]. In further analyses, the calculated prevalence rate varied depending on subgroup. The pooled incidence rate from the seven eligible studies analysed was 1928 per 100 000 person-years (PY; 95% CI -439 to 4294). CONCLUSIONS This comprehensive meta-analysis provides an updated global prevalence rate of AK of 14%, indicating a significant worldwide disease burden. The incidence rate of AK was found to be 1928 per 100 000 PY, emphasizing a growing public health concern. However, high heterogeneity among studies suggests that various factors influence the AK prevalence rate, necessitating further research to understand the observed differences.
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Affiliation(s)
- Christopher D George
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| | - Truelian Lee
- Harvard Medical School, Department of Dermatology, Boston, MA, USA
| | - Loes M Hollestein
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| | - Maryam M Asgari
- University of Colorado Anschutz Medical Campus, Department of Dermatology, Aurora, CO, USA
| | - Tamar Nijsten
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
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Abstract
OBJECTIVES To systematically assess the prevalence and risk factors for senile pruritus (SP) in the elderly (≥60 years of age). DESIGN A meta-analysis was used to pool the prevalence and risk factors for SP estimated from individual studies. Four subgroup analyses were conducted to explore the prevalence for SP in different age, sex, research sites and region. SETTING, PARTICIPANTS AND MEASURES SP reduces quality of life in the elderly, yet the worldwide prevalence is unclear. Moreover, the risk factors for SP are controversial. Data from cross-sectional studies, case-control studies, longitudinal studies and cohort studies that reported the prevalence or the risk factors for SP were collected by searching nine electronic databases up to October 2020, including Web of Science, PubMed, Embase, Cochrane Library, CINAHL, CBM, CNKI, Wanfang and VIP. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed methodological quality. Data analysis was performed using Stata V.15.1 software. RESULTS Seventeen studies involving 28 666 participants were included. The overall pooled prevalence of SP was 21.04% (95% CI 11.37% to 32.72%). In addition, the results showed that smoking, excessive drinking and monophagism were possible risk factors for SP, with pooled ORs of 1.26 (95% CI 1.14 to 1.40), 25.03 (95% CI 18.28 to 34.25) and 1.22 (95% CI 1.12 to 1.33), respectively. CONCLUSIONS The overall prevalence of SP was high. Smoking, excessive drinking and monophagism were possible risk factors for SP. PROSPERO REGISTRATION NUMBER CRD42019143295.
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Affiliation(s)
- Shi Chen
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University & West China School of Public Health, Sichuan University, Chengdu, China
| | - Faquan Zhou
- Department of General Surgery, The General Hospital of Western Theater Command, Chengdu, China
- North sichuan medical college, Nanchong, China
| | - Yiquan Xiong
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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3
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Huang Y, Liu J, Zhang X, Li Y, Xu Y, Xiong X, Deng Y. Patients with senile pruritus have a distinct skin microbiota and epidermal barrier in comparison with healthy controls. J Dermatol 2021; 48:1892-1899. [PMID: 34634142 DOI: 10.1111/1346-8138.16153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
Senile pruritus (SP) is a common skin disease in the elderly. The role of skin dysbacteriosis in the development of various skin diseases has been studied in recent years. However, the research about the skin microbiota of senile pruritus patients is lacking at present. The purpose of this cross-sectional study was to investigate the differences of skin microbiota in senile pruritus patients and their relationship with the epidermal barrier. Thirty patients with senile pruritus and 30 age- and sex-matched healthy controls were enrolled in this study. The skin barrier indexes were recorded by multi-functional skin tester. The skin bacterial diversity was analyzed by using hyper-variable tag sequencing of the V3-V4 region of the 16S rDNA. Compared with the healthy control group, the patients had significantly lower skin hydration (p = 0.014) and higher pH value (p = 0.021). Skin microbial diversity was significantly increased in patients according to the alpha diversity. At the genus level, Acinetobacter (p = 0.002) and Lactobacillus (p = 0.002) increased and Cutibacterium (p = 0.043) decreased. The pH value was positively associated with observed_species diversity (p = 0.026). The transdermal water loss was negatively related to the genus of Lactobacillus (p = 0.036), while the skin hydration was positively associated with the genus of Lactobacillus (p = 0.038). As a result, the damaged skin barrier function and skin dysbacteriosis complemented each other and may be associated with the occurrence of senile pruritus, but their role still needs further study.
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Affiliation(s)
- Yaxin Huang
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jiexiong Liu
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,International Cooperation Center, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xiaorong Zhang
- Chongqing University Three Gorges Hospital, Wanzhou, Chongqing, China
| | - Yujuan Li
- Health Management Center, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yong Xu
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, Sichuan, China.,Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Xia Xiong
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yongqiong Deng
- Department of Dermatology STD, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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4
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Darjani A, Alizadeh N, Rafiei E, Moulaei M, Naseri Alavi SH, Eftekhari H, Rafiei R, Gharaei-Nejad K, Mohtasham-Amiri Z. 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.
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Affiliation(s)
- Abbas Darjani
- Department of Dermatology, Guilan University of Medical Sciences, Rasht, Iran
| | - Narges Alizadeh
- Department of Dermatology, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Rafiei
- Department of Dermatology, Guilan University of Medical Sciences, Rasht, Iran
| | | | | | - Hojat Eftekhari
- Department of Dermatology, Guilan University of Medical Sciences, Rasht, Iran
| | - Rana Rafiei
- Department of Dermatology, Guilan University of Medical Sciences, Rasht, Iran
| | - Kaveh Gharaei-Nejad
- Department of Dermatology, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Mohtasham-Amiri
- Preventive and Community Department, Guilan University of Medical Sciences, Rasht, Iran
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Abstract
Aim: To explore the pattern of occurrence and characteristics of senile pruritus among elderly living in nursing homes in the Northern region of Denmark. Materials & methods: A Danish questionnaire was developed and distributed to six nursing homes from which 46 residents participated. Results: The prevalence of chronic itch was 28.9%. Evening–night and autumn–winter with an average daily itch of 30 min were reported. Itch interfered with night sleep and daily activities. Scratching was common with 61.5% accompanying scratch marks. Half of participants reported Xerosis. Cream, cold compress and cold shower were found to be the most effective remedies for itch relief. Conclusion: The present study revealed a high prevalence of chronic pruritus including cases of senile pruritus that needs further exploration for treatment or preventive strategies. Senile pruritus is chronic itch of unknown origin among the elderly. The occurrence and characteristics among Danish nursing home residents was not known. We developed a Danish questionnaire and distributed it to 6 nursing homes, where 46 residents participated. We found a high prevalence of chronic itch (28.9%). Disturbing itch was reported in evening–night and autumn–winter. Itch interfered with night sleep and daily activities. Scratching was common with scratch marks. Showering precipitated itch, while cold shower was a reliever. Further studies are required to enhance the knowledge about senile pruritus and prevention or treatment strategies for elderly living in nursing homes.
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6
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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
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7
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Darjani A, Rafiei R, Shafaei S, Rafiei E, Eftekhari H, Alizade N, Gharaei nejad K, Rafiee B, Najirad S. Evaluation of Lipid Profile in Patients with Cherry Angioma: A Case-Control Study in Guilan, Iran. Dermatol Res Pract 2018; 2018:4639248. [PMID: 29861719 PMCID: PMC5971275 DOI: 10.1155/2018/4639248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/04/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Cherry angioma is the most common type of acquired cutaneous vascular proliferation which would increase with aging due to some angiogenic factors but the exact pathogenesis is unknown. Usually angiogenic factors are synthesized in human body to compensate occlusive effects of atherogenic agents such as serum lipids. Our hypothesis was that increased levels of these angiogenic factors could be a trigger for development of cherry angioma. This study has been designed to compare frequency of dyslipidemia in subjects with and without cutaneous cherry angioma. METHODS In this case-control study, 122 cases with cherry angioma and 122 control subjects without cherry angioma were enrolled. Demographic characteristics, number of the cherry angioma lesions, and serum lipid profile were collected for all subjects. The data was analyzed using SPSS 18 software. RESULTS Mean levels of the total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein were higher in patients with cherry angioma compared to control subjects in which differences were significant for total cholesterol, low-density lipoprotein, and triglyceride (P < 0.05) but not for high-density lipoprotein level. CONCLUSION Serum lipids may have a role in producing angiogenic factors and development of cherry angioma and it seems logical to evaluate lipid profile in these cases.
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Affiliation(s)
- Abbas Darjani
- Skin Research Center, Dermatology Department, Guilan University of Medical Sciences, Razi Hospital, Sardare Jangal Street, Rasht, Iran
| | - Rana Rafiei
- Fellowship of Dermatopathology, Skin Research Center, Dermatology Department, Guilan University of Medical Sciences, Razi Hospital, Sardare Jangal Street, Rasht, Iran
| | - Sareh Shafaei
- Skin Research Center, Dermatology Department, Guilan University of Medical Sciences, Razi Hospital, Sardare Jangal Street, Rasht, Iran
| | - Elahe Rafiei
- Razi Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hojat Eftekhari
- Skin Research Center, Dermatology Department, Guilan University of Medical Sciences, Razi Hospital, Sardare Jangal Street, Rasht, Iran
| | - Narges Alizade
- Skin Research Center, Dermatology Department, Guilan University of Medical Sciences, Razi Hospital, Sardare Jangal Street, Rasht, Iran
| | - Kaveh Gharaei nejad
- Skin Research Center, Dermatology Department, Guilan University of Medical Sciences, Razi Hospital, Sardare Jangal Street, Rasht, Iran
| | - Behnam Rafiee
- Department of Pathology, NYU Winthrop Hospital, 222 Station Plaza, No. 620, Mineola, NY 11501, USA
| | - Sara Najirad
- Department of Internal Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA
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8
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Gojani PJ, Masjedi M, Khaleghipour S, Behzadi E. Effects of the Schema Therapy and Mindfulness on the Maladaptive Schemas Hold by the Psoriasis Patients with the Psychopathology Symptoms. Adv Biomed Res 2017; 6:4. [PMID: 28217649 PMCID: PMC5309440 DOI: 10.4103/2277-9175.190988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND This study aimed to compare the effects of the schema along with mindfulness-based therapies in the psoriasis patients. MATERIALS AND METHODS This semi-experimental study with post- and pre-tests was conducted on the psoriasis patients in the Dermatology Clinic of the Isfahan Alzahra Hospital, Iran using the convenience sampling in 2014. The patients had a low general health score. The experimental groups included two treatment groups of schema-based (n = 8) and mindfulness (n = 8). Both groups received eight 90-min sessions therapy once a week; they were compared with 8 patients in the control group. To evaluate the psoriasis patients' maladaptive schema, Young schema questionnaire was used. Data were analyzed through the covariance analysis test. RESULTS There was a significant difference between the schema-based therapy and mindfulness groups with the control group. There was also a significant difference between the schema-based therapy groups consisting of the defeated schema, dependence/incompetence schema, devotion schema, stubbornly criteria schema, merit schema, restraint/inadequate self-discipline schema, and the control group. Moreover, a significant difference existed between the maladaptive schema of mindfulness therapy group and the controls. There was a significant difference concerning the improvement of the psychopathologic symptoms between the mindfulness therapy group and the control group. CONCLUSIONS This study showed similar effects of both the schema and mindfulness-based therapies on the maladaptive schemas in improving the psoriasis patients with the psychopathologic symptoms.
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Affiliation(s)
- Parvin Jamali Gojani
- Department of Clinical Psychology, Najafabad Branch, Islamic Azad University, Najafabad, IR Iran
| | - Mohsen Masjedi
- Department of Immunology, Faculty of Medicine, Islamic Azad University, Naein, IR Iran
| | | | - Ehsan Behzadi
- Medical Students' Research Committee, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IR Iran
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Theunis J, Chaussade H, Bourgeois O, Mengeaud V. Efficacy of a Rhealba®Oat Extract-based emollient on chronic pruritus in elderly French outpatients. J Eur Acad Dermatol Venereol 2017; 31 Suppl 1:1-7. [DOI: 10.1111/jdv.14077] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 12/08/2016] [Indexed: 12/28/2022]
Affiliation(s)
- J. Theunis
- Skin Research Center; Pierre Fabre Dermo-Cosmétique; Toulouse France
| | - H. Chaussade
- Private Practice; Saint-Orens de Gameville France
| | - O. Bourgeois
- Private Practice; Saint-Orens de Gameville France
| | - V. Mengeaud
- Skin Research Center; Pierre Fabre Dermo-Cosmétique; Toulouse France
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10
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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: 122] [Impact Index Per Article: 17.4] [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.
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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
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11
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Makrantonaki E, Steinhagen-Thiessen E, Nieczaj R, Zouboulis CC, Eckardt R. Prevalence of skin diseases in hospitalized geriatric patients. Z Gerontol Geriatr 2016; 50:524-531. [DOI: 10.1007/s00391-016-1084-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/26/2016] [Accepted: 05/11/2016] [Indexed: 12/22/2022]
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12
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Skin hydration in nursing home residents using disposable bed baths. Geriatr Nurs 2016; 37:175-9. [DOI: 10.1016/j.gerinurse.2015.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 11/18/2015] [Accepted: 11/23/2015] [Indexed: 11/19/2022]
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13
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Abstract
Chronic itch in the elderly is a common problem, with a significant impact on quality of life and sleep in elderly patients. Chronic itch may be attributable to several causes, including dry skin, immunosenescence and neural degeneration. Itch may also be caused by skin diseases, such as seborrhoeic dermatitis and stasis dermatitis; systemic conditions, such as end-stage renal disease and diabetes; and psychogenic conditions, such as depression and anxiety. The use of polypharmacy may also cause itch, with or without a rash. Specifically, thiazides and calcium channel blockers have been known to cause itch in elderly patients. Management should be tailored according to the underlying dermatological or systemic aetiology of itch. Topical treatment is the mainstay of therapy, providing special emphasis on skin hydration and barrier repair. In addition, topical and oral medications that target the nervous system and reduce neuronal hypersensitization, such as gabapentin and selective antidepressants, have a role in treating patients with severe chronic itch. Furthermore, management must account for changes in metabolism and pharmacokinetics of drugs in the aging population in order to prevent the occurrence of adverse effects.
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14
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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.
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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
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15
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Kartal D, Çınar SL, Akın S, Ferahbaş A, Borlu M. Skin findings of geriatric patients in Turkey: A 5-year survey. DERMATOL SIN 2015. [DOI: 10.1016/j.dsi.2015.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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16
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Environmental and Genetic Factors on the Development of Onychomycosis. J Fungi (Basel) 2015; 1:211-216. [PMID: 29376909 PMCID: PMC5753111 DOI: 10.3390/jof1020211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/15/2015] [Accepted: 08/19/2015] [Indexed: 11/17/2022] Open
Abstract
Since the early 20th century, onychomycosis originated with the onset of war, the use of occlusive footwear, and the mass migration of people by transportation in the United States. Even though onychomycosis has a high prevalence in the US, other parts of the world including Canada, West Africa, Southeast Asia, Northern Australia, and Europe have been well documented with cases of fungal toenail infection in their environments. Trichophyton rubrum (T. rubrum) is the major dermatophyte responsible for toenail fungal infection and is typically diagnosed in conjunction with tinea pedis, especially in individuals older than 60 years. Gender roles, age, cultural habits, shoe gear, sports activities, and genetic predisposition all contribute to the different presentation of onychomycosis in these areas where organisms like dermatophytes, candida, and molds were isolated in a variety of cases. Despite the differences in isolated pathogens, treatment outcomes remained consistent. This literature review discusses the influence of tinea pedis, genetics, shoe gear, sports, and age on the development of onychomycosis.
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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
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Nair PA, Vora R. Association of systemic diseases with cutaneous dermatosis in elderly population: preliminary observation at a rural tertiary care centre. J Family Med Prim Care 2015; 4:74-8. [PMID: 25810993 PMCID: PMC4367010 DOI: 10.4103/2249-4863.152259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Introduction: Aging population is susceptible to many cutaneous and systemic diseases, simultaneously leading to impairment of quality of life in them. Aim: To know the association of dermatosis and systemic diseases in geriatric age group. Materials and Methods: A retrospective study was carried on patients above 60 years of age who visited the Dermatology OPD at rural tertiary care centre from June 2009 to May 2010. Patients were assessed on a prescribed 30 point proforma. Results: Total 457 geriatric patients with dermatosis were registered under the study, of these 203 patients had one or more systemic diseases. Hypertension (70.9%) was the commonest disease, followed by diabetes (32.5%). Eczema was commonest dermatosis in patients with hypertension and generalized pruritus in diabetes. Conclusion: Skin diseases cause considerable morbidity in elderly, particularly if associated with other comorbid conditions, so health promotion and education can do much to reduce the risk.
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Affiliation(s)
- Pragya A Nair
- Department of Dermatology, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Rita Vora
- Department of Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India
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