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Geriatric Dermatology

»	How common are skin disorders in the elderly population?
»	What is intrinsic aging of the skin?
»	What is extrinsic aging of the skin?
»	How does intrinsically aging human skin vary from young skin under the microscope?
»	Why does skin wrinkle as we age?
»	Does smoking cigarettes accelerate skin aging?
»	What is solar elastosis?
»	What is nodular elastosis with cysts and comedones?
»	How do liver spots, solar lentigo, and lentigo senilis differ?
»	Why do elderly patients frequently develop bleeding into the skin on the dorsum of their hands and arms?
»	Advertisements in newspapers and magazines frequently tout products that “rejuvenate” the skin or make the skin younger. Is there truth to these claims?
»	What is the difference between superficial, medium, and deep chemical peels?
»	Are some sunscreens better than others in preventing wrinkles due to photodamage?
»	Which are the most common inflammatory skin diseases in the elderly?
»	Why are elderly patients prone to develop xerosis?
»	What is the best way to treat xerosis?
»	How common is chronic venous insufficiency in the geriatric population?
»	Explain the pathogenesis of chronic venous insufficiency.
»	How should you manage chronic venous insufficiency?
»	What is rosacea? How does it present?
»	Is rhinophyma related to alcohol abuse?
»	Name the most common types of skin tumors seen in the elderly.
»	What are seborrheic keratoses?
»	What are stucco keratoses?
»	What is sebaceous hyperplasia?
»	A 70-year-old man presents to your clinic with the sudden onset of hundreds of seborrheic keratoses. Is there any reason for concern?
»	Describe the methods for treating seborrheic keratoses.
»	An elderly man presents with a soft blue papule on the helix of his cheek and is concerned about malignant melanoma. What is the most likely diagnosis?
»	Is there a future in geriatric dermatology?

What is extrinsic aging of the skin?

Extrinsic aging of the skin consists of those changes produced by external agents. The most important extrinsic factor is cumulative ultraviolet (UV) light exposure. The cutaneous changes produced by sunlight are collectively referred to as dermatoheliosis. Most of the changes associated with aging of the skin, such as wrinkles, yellow leathery skin, thin skin, hyperpigmentation, hypopigmentation, lentigo senilis (liver spots), telangiectasias, and senile (solar) purpura, are all secondary to damage from the sun or other UV light sources such as tanning booths. Less important extrinsic agents that accelerate aging of the skin include smoking and possibly environmental pollutants.

Fitzpatrick JE, Schleve MJ: Geriatric dermatology. In Jahnigen DW, Schrier RW, editors: Geriatric medicine, ed 2, Cambridge, 1996, Blackwell Science, pp 823–836.