A Clinico-Epidemiological Study of Geriatric Dermatoses

Dr. Awani Kansagra

3rd Year Postgraduate Resident

Department of Dermatology

National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India

Dr. Vishal S. Patel

MD (Skin), Fellowship in Hair transplant

Consultant at AV Skin, Laser & Hair Transplant Clinic

Rajkot, Gujarat, India

Dr. Sanjay Kanodia

MD (Dermatology)

Professor

Department of Dermatology

National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India

Abstract

Background: Increasing number of geriatric population is noted to have characteristic group of dermatoses called geriatric dermatoses. Ageing population is dramatically increasing with increase in average life and is faced with different health problems including skin. The aim was to study the clinical pattern of geriatric dermatoses and associated systemic diseases.

Materials and Methods:

The present study was hospital-based cross-sectional observational study, conducted in Department of Dermatology over a period of one and a half year from January 2021 to June 2022 at a tertiary care hospital. A total of 350 cases with age 60 years and above from OPD/IPD were chosen as study group.

Results: Out of 350 patients; 251(71.71%) were males and 99 (28.29%) were females, male:female ratio was 2.5:1.

Wrinkling (100%) and graying of hair (98.57%) were the commonest physiological changes observed. Among pathological changes infections and infestations was the commonest seen in 22.57%.

Hypertension (28.29%) was the commonest systemic disease followed by Diabetes Mellitus (17.14%) in study population.

Conclusion: This study concluded that, through knowledge regarding spectrum of geriatric dermatoses is important as it is rapidly changing with wide variety of physiological and pathological skin changes. Thus early detection and proper management is very important and improving QOL in this age group of patients.

Keywords: Geriatric dermatoses, Ageing, Xerosis.

Introduction

“Geriatric” is the term used for population aging 60 years and above.1 Aging is the term used for progressive reduction and decline capacity in function of various organs and systems of the body including skin.

Aging is a process of progressive reduction in maximal functioning and reserve capacity of all organs in body including skin.2 Skin undergoes intrinsic and extrinsic aging.3 Intrinsic skin aging is inevitable physiological changes affecting all persons. It is characterized by thinning of upper layer of skin, reduced amount of lipids, decrease blood flow and collagen fragmentation leading to dry, pale skin with fine wrinkles.4 Extrinsic skin aging also known as photoaging is related to exposure of UV radiation resulting in accumulation of abnormal elastin and disintegration of collagen fibrils presenting with coarse wrinkles, skin laxity, hyperpigmentation, senile lentigines, freckles and leathery skin appearance.

Common dermatological manifestation in elderly are xerosis, wrinkles, senile pruritus, infections like herpes zoster, superficial fungal infections, scabies and other infestations, eczematous conditions like asteatotic eczema, stasis eczema, papulosquamous disorders, photoaging (dermatoheliosis), benign tumors like acrochordons, seborrheic keratosis and cherry angioma. Skin cancers which includes: basal cell carcinoma, squamous cell carcinoma, age spots and bed sores are common in the geriatric population as compared to young population.5

Aim

To study the clinical profiles of various geriatric dermatoses.

Objective

• To identify clinical patterns of various dermatological disorders in elderly.

• To determine factors contributing to these dermatoses and their association with systemic disease (if any).

Material And Methodology

The present study was a Hospital-based Cross-sectional observational study, conducted at a Department of Dermatology, Venereology and Leprology, tertiary care hospital from January 2021 to June 2022. A total of 350 patients with the age ≥60 years and above are recruited in our study after written informed consent.

A detailed history was taken, complete general physical and systemic examination was done. Relevant investigations were performed wherever required.

Inclusion criteria

Patients of age ≥60 years attending outpatient and indoor department willing to participate were included in the study.

Exclusion criteria

Patients unwilling to give consent were excluded from the study.

Statistical Analysis

• After collecting the data, statistical analysis was done by using Microsoft Excel 2010 / SPSS software v27.

Results

In this study out of 350 patients, 251 (71.71%) were males and 99 (28.29%) were females. Male:female ratio was 2.5:1.

In this study, 350 patients were categorized into four age groups. Among the age groups, maximum number of patients 260 (74.28%) belonged to age group of 60-70 years followed by 80 (22.85%) in age group of 71-80 years, 9 (2.57%) in age group from 81-90 years, only 1 case lies in the age group of 91100 years.

Majority of the male patients were agricultural worker 136 (38.85%) and most of the female patients were housewives 77 (22%). Maximum numbers of patients were from the rural background and lower socioeconomic status.

All the patients showed signs of aging. Among them, commonest was skin wrinkling (350, 100%) and greying of hair (345, 98.57%) followed by skin xerosis (153, 43.71%), idiopathic guttate hypomelanosis (43,12.28%), senile purpura (42, 12%), senile comedo (33, 9.42%), seborrheic keratosis (29, 8.28%), acrochordon and fissured soles