DermHelpCentral

Geriatric Dermatology: An Overview

by Douglas W. Johnson, M.D.
Chief, Division of Dermatology
J A Burns School of Medicine
University of Hawaii

 

Geriatric Dermatology: Download Geriatric Dermatology

Senile Gluteal Dermatosis

Senile gluteal dermatosis: a clinical study of 137 cases.
Liu HN1, et. al. Int J Dermatol. 2014 Jan;53(1):51-5.
Abstract
BACKGROUND: Senile gluteal dermatosis (SGD) is a common genital dermatosis but has gained little attention before. A large-scale clinical study of this disease is lacking.

MATERIALS AND METHODS: We examined 162 consecutive outpatients with gluteal skin diseases of different causes. Fourteen skin biopsies were performed. Patient's age, gender, body mass index (BMI), way of sitting or lying, treatment response, and underlying systemic diseases were recorded.

RESULTS: About 137 (85%) patients could be defined as SGD. These patients, with a mean age of 79.4 ± 40.7 years and a mean BMI of 21.7 ± 10.8, presented with either partial (n = 43, 31%) or full-blown (n = 94, 69%) SGD lesions characterized by the sign of so-called "three corners of a triangle": brownish plaques on the gluteal cleft and each side of the buttocks. Male/female ratio was 130/7. Itching or pain of varying intensity was reported by 50 patients (36%) and 14 patients (10%), respectively. Eighty-six patients (53%) presented with horizontal hyperkeratotic ridges, a characteristic sign of SGD. Most patients spent most of the day sitting but reported no special way of sitting or lying. More than half of patients with SGD claimed no response to topical steroids and/or keratolytics. In comparison with patients with SGD, SGD-free patients were younger (61.3 ± 36 years, P = 0.0005) and heavier (BMI 26.2 ± 15.6, P < 0.0001) but showed no significant difference in the frequency of underlying systemic diseases.

CONCLUSIONS: SGD is a common dermatosis, mostly affecting the thinner elderly. Friction, pressures and long hours sitting seemed to be important factors to trigger this dermatosis.

Comment:  This is a common problem in the elderly.  The name here is unfortunate, but it is descriptive.  This is one of the only articles about this disorder. This has been also called "Sitter's Sign." Download Sitter's Sign

After The Fall

As the population ages and people live longer in bad shape, the number of older Americans who fall and suffer serious, even fatal, injuries is soaring.  This is a two part article on falls in the elderly.  It is comprehensive and very well done.

Part I: Bracing for the Falls of an Aging Nation

Part II: A Tiny Stumble, a Life Upended

 

Pressure Sores in the Elderly

The elderly can spend a lot of time in bed or sitting in a recliner.  This can contribute to the development of pressure sores.  Fecal or urinary incontinence can accelerate this process as well as other factors.

Dr. Robert Norman is a dermatologist in Tampa, Florida.  He has a special interest in geriatric dermatology.  Attached are some forms that will help to evaluate a patient's risk of dseveloping pressures ulcers (bed sores)

Dr. Norman's intake form: Download Wound care NORMAN SCALE aug 07