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Feature Article

A guide to skin conditions in older people

Shreya Dixit, Stephen Shumack

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An updated version is available in the linked supplement

Abstract

The dermatoses associated with ageing can, at times, be severely debilitating and it is important to be aware of the more common presentations so that early intervention can be commenced.

Key Points

  • Skin ageing occurs via two pathways: intrinsic ageing and photoageing.
  • The skin conditions most commonly seen in the elderly are xerosis, onychomycosis, dermatitis and skin cancer.
  • Regular skin checks are recommended in elderly patients who have had excessive cumulative sun exposure, whether or not they have a history of skin cancer.
  • Scabies spreads rapidly within nursing homes. However, it is relatively underdiagnosed because the lesions may be atypical. Burrows should be looked for in the web spaces between fingers, in the creases of the wrists and elbows, and on the palms and soles.
  • Adverse drug reactions are common in older patients, and are due in part to polypharmacy and comorbidities. Prompt identification and withdrawal of the drug can limit toxic effects.

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