A Clinical Analysis of Skin Disease among the Elderly in the Western Gyeongnam Province

Kim, Seok Rim; Park, Dong Hwa; Kim, Chi Yeon

Abstract

BACKGROUND
With the advancement of socioeconomic and medical sciences, the number of elderly patients with skin diseases significantly increased. Therefore, the epidemiologic survey of dermatologic disease is in need for the elderly population.
OBJECTIVE
The purpose of this study was to evaluate the prevalence of dermatologic diseases in elderly patients and to compare the results with the previous reports in malignant and benign skin tumors.
METHODS
We retrospectively reviewed the clinical records of 2,678 outpatients older than 65 years of age, who visited the Department of Dermatology from January 2010 to December 2013. We compared the clinical diagnoses and analyzed the distribution of dermatologic diseases and clinical features, including the factors of age and sex. Among them, 575 patients who received biopsy for skin tumors were pathologically analyzed, confirmed, and classified as malignant or benign tumor.
RESULTS
The incidence of skin disease in the group of patients older than 65 years of age was 15.6% (2,678). The ratio of men to women was 1 : 1.13 (1,257 : 1,421). The types of skin diseases in the group were as follows: infectious skin disease (26.1%); eczema (23.2%); epidermal and adnexal nevi and tumors (17.5%); drug eruption, erythema, and urticaria (7.0%); pruritus, psychocutaneous disorder, and neurocutaneous dermatoses (6.6%); papulosquamous disease (3.3%); diseases of the skin appendages (3.2%); disorders of pigmentation (2.5%); diseases of the mucous membrane (2.3%); cutaneous vascular diseases (2.2%); and skin tumors (21.5%). The most common malignant tumors were as follows: squamous cell carcinoma (33.9%), basal cell carcinoma (31.2%), Bowen's disease (19.0%), keratoacanthoma (7.2%), malignant melanoma (5.0%), and lymphoma (1.8%). The most common benign tumors were as follows: actinic keratosis (48.0%), seborrheic keratosis (17.2%), epidermal cyst (12.7%), melanocytic nevus (6.2%), hemangioma (3.7%), milia (2.0%), and hypertrophic scar and keloid (2.0%). The incidence of malignant tumors in women was much higher than in men, with a ratio of 1 : 1.96.
CONCLUSION
This study provides useful data on the incidence and the characteristics of elderly skin diseases. Compared to the previous studies, the frequency of malignant tumors was relatively higher and variable. We advise physicians to make the appropriate diagnosis and treatment for the early detection of skin tumor, especially the squamous cell carcinoma and basal cell carcinoma, which are caused by long-term exposure to the sun.