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Clinics in Dermatology

Eleonora Ruocco, Ronni Wolf, Stefano Caccavale, Gabriella Brancaccio, Vincenzo Ruocco, Ada Lo Schiavo
No abstract text is available yet for this article.
March 2018: Clinics in Dermatology
Ayse Serap Karadag, Lawrence Charles Parish
Seborrheic keratosis (SK), whose appearance is generally a small roundish reddish to brownish scaling lesion ranging in size from a few mm to many mm, may have a single presentation or be one of many such lesions. Because it is a commonly encountered lesion on the face, trunk, or extemities and is readily recognized clinically, it is infrequently biopsied. When the lesion has an unusual pattern or has become irritated, it may rarely mimic a malignancy,Most patients ignore such common age spots; however, others may have concern about their appearence, in which case the SKs have been surgicaly excised...
March 2018: Clinics in Dermatology
Karlijn Clarysse, Coleen Kivlahan, Ingo Beyer, Jan Gutermuth
Neglect and physical abuse of elderly are worrisome health problems, which are expected to grow even further, considering the aging of the population. By 2060, the number of people aged above 65 years is expected to double, whereas birth rates are low. This trend will cause a significant imbalance between different age groups and put more senior adults at risk for abuse. Risk factors, associated with abuse and neglect, are well established and can be categorized in sociodemographic-, victim-, or perpetrator-related risk factors...
March 2018: Clinics in Dermatology
Artem M Sergeyenko, David J Rosenfeld, Maria M Tsoukas
In the ever-aging population of the world, the field of geriatrics continues to grow in importance. As human beings age, the skin undergoes a unique array of changes that predispose it to a specific set of dermatoses, infections, and neoplasms. Some of these physiologic alterations are comparable to the changes that happen in immunosuppressed individuals. Given the importance of immunosuppressive medications in treatment of many common skin conditions, we have reviewed the current literature to assist the practicing clinician in using immunosuppressive medications in the geriatric population...
March 2018: Clinics in Dermatology
Ronni Wolf, Branka Marinović
The world's population is now ageing at an unprecedented rate. Declining fertility and improved health and longevity have generated rising numbers and proportions of the older population in most parts of the world. With advancing age, however, comes an increasing incidence of disease (comorbidity or multimorbidity), an increasing use of medications (polypharmacy), and consequently an increase in adverse drug reactions (ADRs). Age-related changes in pharmacodynamics and pharmacokinetics (eg, volumes of drug distribution, metabolism and clearance, altered drug responsiveness and toxicity) and greater vulnerability to ADRs are other reasons for the higher incidence of ADRs in the elderly compared with young adults...
March 2018: Clinics in Dermatology
Laura Buford, Rebecca Kaiser, Vesna Petronic-Rosic
Aging results in both anatomic and physiologic changes in the skin's structure and vascular system. These vascular changes result in a wide array of dermatologic findings, ranging from the benign to the highly morbid. Herein, we review the impact of both intrinsic and common extrinsic factors of aging on cutaneous vasculature and highlight the manifestations of microvascular, venous, arterial, lymphatic, and neuropathic alterations in the geriatric population.
March 2018: Clinics in Dermatology
Ines Lakoš Jukić, Sandra Jerković Gulin, Branka Marinović
Autoimmune blistering diseases (AIBD) are a group of chronic diseases affecting the skin and mucous membranes, with different presentation, clinical course, histologic and immunopathologic findings, and different therapeutic approach. Blisters develop as a result of autoantibodies directed against distinct adhesion structures within desmosomes or within the basement membrane zone. The most common AIBD that develops in the elderly is bullous pemphigoid (previously also named "pemphigoid senilis"), but mature patients can also present with other AIBD as mucous membrane pemphigoid, epidermolysis bullosa acquisita, paraneoplastic pemphigus, pemphigus vulgaris, pemphigus foliaceus, linear IgA dermatosis, and dermatitis herpetiformis...
March 2018: Clinics in Dermatology
Krešimir Kostović, Kristina Žužul, Romana Čeović, Zrinka Bukvić Mokos
Management of psoriasis in elderly patients may be challenging due to a small number of studies investigating this specific population. When treating a mature patient, special consideration should be given to multiple comorbidities, progressive functional impairment of several organs, immunosenescence, possible adverse effects, and polypharmacy. Due to the chronic nature of the disease and continuing rise in life expectancy, the prevalence of psoriasis among elderly is also expected to rise. Because many different therapies are available for treatment of psoriasis, we have reviewed those that have been investigated in the aging population...
March 2018: Clinics in Dermatology
Natalie Matthews, Vivian Wong, Joe Brooks, George Kroumpouzos
Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis...
March 2018: Clinics in Dermatology
Richard E Watchorn, Christopher B Bunker
Elderly men are at higher risk of developing genital dermatologic problems, including inflammatory and neoplastic conditions due to age-related physiologic changes, immunosenescence, comorbidities, and iatrogenesis. Clinical manifestations of genital dermatoses in men are varied and may include itching, pain, redness, dermatitis, lumps, and ulcers. Even when asymptomatic, the psychologic impact may be significant. Sexual or urinary dysfunction may complicate genital dermatoses. Early and accurate diagnosis is essential to reduce morbidity and mortality from premalignant and malignant conditions and also to prevent sexual dysfunction and unnecessary anxiety in the case of benign entities...
March 2018: Clinics in Dermatology
Maria Cristina Ribeiro de Castro, Marcia Ramos-E-Silva
Dermatologists must be familiar with the peculiarities of the micro-organisms that may affect the elderly, in order to optimize the diagnosis and treatment of infections, which may affect their skin, especially because the world population is rapidly aging. It is estimated that there will be 434 million individuals over 80 years of age in 2050. Since the elderly population is rapidly increasing and their infections are usually more severe and different from those observed in younger adults, it leads to a statistical increase of the rates regarding hospitalization and mortality caused by infectious diseases among people over 85 years...
March 2018: Clinics in Dermatology
Romana Čeović, Mikela Petković, Zrinka Bukvić Mokos, Krešimir Kostović
Nonmelanoma skin cancer (NMSC) is the most common cancer, with the median age at NMSC diagnosis is 71 years. Treatment options for NMSC include surgical therapy, which is usually the first-choice treatment, and nonsurgical modalities. Therapeutic modalities depend on tumor localization, histologic type, and biologic behavior, as well as patient comorbidities, age, and life expectancy. Nonsurgical treatments include cryotherapy, local therapies (imiquimod, 5-fluorouracil, ingenol mebutate, and diclofenac), photodynamic therapy, radiotherapy, and hedgehog inhibitors...
March 2018: Clinics in Dermatology
Vivien Lai, William Cranwell, Rodney Sinclair
Epidermal cancers include keratinocyte cancer, melanocyte cancer, and Merkel cell carcinoma. These cancers account for the vast majority of new cancers diagnosed in Australia, North America, and Europe. Keratinocyte cancer is the most common epidermal cancer and accounts for 7 out of 8 new cancers diagnosed in Australia. Melanoma and Merkel cell carcinoma are less common than keratinocyte carcinoma but are more important causes of mortality in Australia. Keratinocyte cancer has also been demonstrated to be a marker of cancer-prone phenotype...
March 2018: Clinics in Dermatology
Austin John Maddy, Antonella Tosti
The elderly population is growing, lifespans are increasing, and a greater emphasis on geriatric care is being implemented in hospital systems. With a higher percentage of the population living longer, hair and nail diseases associated with the advanced stages of life are becoming more prevalent. Common hair diseases in the elderly include androgenetic alopecia, senile alopecia, frontal fibrosing alopecia, and erosive pustular dermatosis of the scalp. Nail diseases associated with advanced age include onychomycosis, brittle nails, onychocryptosis, onychoclavus, onychogryphosis, subungual hematomas, subungual exostosis, myxoid cysts, and malignancies...
March 2018: Clinics in Dermatology
Zrinka Bukvić Mokos, Danijela Ćurković, Krešimir Kostović, Romana Čeović
During the aging process, the appearance of the human face changes significantly due to fundamental alterations in the bones, soft tissues, and skin. Both endogenous and environmental factors are involved in age-related transformations of the face; however, facial skin is particularly influenced by environmental factors, and the risk of overexposure and consequent premature facial aging. This review summarizes the current state of knowledge of the most common facial skin changes in the mature patient, including pathogenesis of both intrinsic and extrinsic skin aging, as well as clinical and histologic features of skin aging...
March 2018: Clinics in Dermatology
Alina Shevchenko, Rodrigo Valdes-Rodriguez, Gil Yosipovitch
Chronic itch is a common and debilitating health condition in the elderly. There are several common causes of itch in the mature population, such as skin xerosis, immunosenescence, and neuropathic changes. In addition, skin diseases, such as seborrheic dermatitis and stasis dermatitis, systemic conditions (end-stage renal disease and diabetes), or psychogenic derailments, such as depression, anxiety, and dementia, can all serve as triggers of pruritus. Polypharmacy, a common occurrence among the elderly population, may also serve as a cause of itch that may or may not be accompanied by dermatitis...
March 2018: Clinics in Dermatology
Zrinka Bukvić Mokos, Anamaria Jović, Romana Čeović, Krešimir Kostović, Ivica Mokos, Branka Marinović
With the tremendous increase in the proportion of seniors in the global population, geriatric health care has become of greater interest and concern. Increased emphasis on geriatric medicine, along with the growth in the development of age-related skin disorders, has led to particular attention for geriatric, dermatology and dermatopharmacology. An aging population has brought many therapeutic challenges that we need to recognize and overcome by applying geropharmacologic principles. The purpose of this paper is to inform dermatologists of the age-related changes in the pharmacokinetics of common dermatologic drugs, their various interactions potentially occurring in the elderly, and the principles and evidence-based strategies for detection, management, and prevention to improve medication adherence...
March 2018: Clinics in Dermatology
Laura Atzori, Caterina Ferreli, Franco Rongioletti
Skin diseases in the elderly are frequent and sometimes misleading, due to age-related changes that alter the clinical presentation. Clinicopathologic correlation is often the clue for distinguishing among various pathologies for which clinical signs are more striking than the histopathologic findings. Pitfalls are always lying in wait to ambush inexperienced dermatologists, but usually the microscope provides subtle hints to solve the quandary. In an attempt to familiarize physicians with emerging skin care demands of older patients, we have reviewed major diagnostic challenges in this group of patients: age-related changes, more common skin pathologies in mature patients, manifestations of comorbidity, skin tumors, and paraneoplastic syndromes...
March 2018: Clinics in Dermatology
Ružica Jurakić Tončić, Sanja Kezić, Suzana Ljubojević Hadžavdić, Branka Marinović
Dry skin is the most common clinical manifestation of dermatologic diseases, and it presents with itching, redness, and desquamation-signs and clinical manifestations that are not only physically uncomfortable but also affect patients psychologically. The water content in the stratum corneum is largely dependent on the composition and amount of the intercellular lipids, which regulate the loss of water from the skin, and on the levels of hygroscopic substances of the natural moisturizing factors, which are responsible for retention of water in the stratum corneum...
March 2018: Clinics in Dermatology
Branka Marinović
No abstract text is available yet for this article.
March 2018: Clinics in Dermatology
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