Korean J Dermatol.  2023 Jun;61(5):293-298.

Clinical Characteristics of Late Adult-Onset Elderly Atopic Dermatitis

• Kim TE
• Shin MK

Abstract

Background
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by typically distributed eczematous skin lesions and is classified according to the period of life. Recently, the number of elderly patients newly diagnosed with AD have been increased in industrialized countries.
Objective
This study aimed to analyze the clinical characteristics of late adult-onset elderly AD.
Methods
Medical charts and photographs of patients aged 60 years or older (n=36) who visited the Department of Dermatology with chronic and recurrent dermatitis were analyzed retrospectively. The anatomical distribution of AD lesions was evaluated by categorizing them into head and neck, trunk, and upper and lower extremities. The results of laboratory tests related to AD were also analyzed.
Results
Thirty-six patients were diagnosed with elderly AD according to the diagnostic criteria established by Hanifin and Rajka, with a male predominance. All patients had late adult-onset AD, with the primary onset of AD occurring after the age of 40 years. Eczematous erythroderma, lichenification, dryness, and pruritic papules were observed on the trunk and extremities. The proportion of patients with extrinsic AD was 54.8%, and that of patients with one or more allergic diseases was 25.0%. Patients with late adult-onset elderly AD had lesions in the sagging areas, such as the back or extensor surface of the extremities.
Conclusion
Male predominance, reverse sign, and involvement of the extensor areas are characteristic features of AD in the elderly. These results indicate that late adult-onset AD in elderly patients is a distinct subgroup of patients with AD.

Keyword

Atopic dermatitis; Geriatrics; Pruritus