10.5826/dpc.1203a145
Introduction: Elderly population is vulnarable to experience a great number of dermatological diseases thanks to the intrinsic and extrinsic process of aging.
Objectives: The aim of this study is to retrospectively investigate the prevalence of dermatological diseases in geriatric patients, their distribution by age and gender, and to provide a reference for studies on aging and skin problems.
Methods: In the present study, patients who reported to the dermatology outpatient clinic between January 1, 2019 and January 1, 2021 were evaluated retrospectively. As a result of examining the records of patients, 887 patients over the age of 65 who met the study protocol were included.
Results: The three most common diseases in all geriatric patients were fungal infections, eczematous dermatitis, and pruritus. Fungal infections were frequent in males and the 65-74 ages group. In the males, the more frequent was precancerous lesions and malignant neoplasms, whereas in the females it was urticaria and adverse drug reactions. In the logistic regression model, the risk of fungal infection in geriatric patients was increased by being male (OR: 1.55 p=0.006) and being in the range of 65-74 years old (OR: 1.46 p=0.025). Male patients were at significantly higher risk for precancerous and malignant lesions (OR:2.81 p&lt;0.001) and actinic keratosis (OR:3.26 p&lt;0.001) in this disease group.
Conclusions: Men are more vulnerable to life-threatening skin diseases. It is important to determine risk factors for individuals who are more sensitive to environmental factors in terms of increasing the quality of life and protection from diseases.
text/xml
2160-9381
2105
en
Tufan Nayir
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
epidemiology
Retrospective Analysis of Dermatological Diseases in Geriatric Patients During Dermatology Outpatient Department Visits
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Original Article
2022-07-28
2021-10-15
2022-07-28
2022-09-13
e2022145
Dermatol Pract Concept
Introduction: Elderly population is vulnarable to experience a great number of dermatological diseases thanks to the intrinsic and extrinsic process of aging.
Objectives: The aim of this study is to retrospectively investigate the prevalence of dermatological diseases in geriatric patients, their distribution by age and gender, and to provide a reference for studies on aging and skin problems.
Methods: In the present study, patients who reported to the dermatology outpatient clinic between January 1, 2019 and January 1, 2021 were evaluated retrospectively. As a result of examining the records of patients, 887 patients over the age of 65 who met the study protocol were included.
Results: The three most common diseases in all geriatric patients were fungal infections, eczematous dermatitis, and pruritus. Fungal infections were frequent in males and the 65-74 ages group. In the males, the more frequent was precancerous lesions and malignant neoplasms, whereas in the females it was urticaria and adverse drug reactions. In the logistic regression model, the risk of fungal infection in geriatric patients was increased by being male (OR: 1.55 p=0.006) and being in the range of 65-74 years old (OR: 1.46 p=0.025). Male patients were at significantly higher risk for precancerous and malignant lesions (OR:2.81 p&lt;0.001) and actinic keratosis (OR:3.26 p&lt;0.001) in this disease group.
Conclusions: Men are more vulnerable to life-threatening skin diseases. It is important to determine risk factors for individuals who are more sensitive to environmental factors in terms of increasing the quality of life and protection from diseases.
Tufan Nayir
2022/07/28
10.5826/dpc.1203a145
e2022145
Republic of Turkey Ministry of Health, Ankara, TR
2160-9381
epidemiology
en
e2022145
Retrospective Analysis of Dermatological Diseases in Geriatric Patients During Dermatology Outpatient Department Visits
https://dpcj.org/index.php/dpc/article/download/2105/1675
                    Dermatology Practical & Conceptual


      Retrospective Analysis of Dermatological
  Diseases in Geriatric Patients During Dermatology
            Outpatient Department Visits
           Gulhan Aksoy Sarac1, Mehmet Ali Can Emeksiz1, Onur Acar2, Ersin Nazlican3,
                                 Efsun Tanacan1, Tufan Nayir4


1 Department of Dermatology and Venereology, Ufuk University Hospital, Ankara, Turkey
2 Ağrı Provincial Health Directorate, Republic of Turkey Ministry of Health, Ağrı, Turkey
3 Department of Public Health, Faculty of Medicine, Çukurova University, Adana, Turkey
4 Republic of Turkey Ministry of Health, Ankara, Turkey



Key words: geriatrics, elderly, skin diseases, dermatology, epidemiology
Citation: Aksoy Sarac G, Emeksiz MAC, Acar O, Nazlican E, Tanacan E, Nayir T. Retrospective analysis of dermatological diseases in
geriatric patients during dermatology outpatient department visits. Dermatol Pract Concept. 2022;12(3):e2022145.
DOI: https://doi.org/10.5826/dpc.1203a145
Accepted: December 23, 2021; Published: July 2022
Copyright: ©2022 Akoy Sarac et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Onur Acar, MD, Ağrı Provincial Health Directorate, Republic of Turkey Ministry of Health, Ağrı, Turkey, E-mail:
dronuracar@yandex.com




  ABSTRACT             Introduction: The elderly population is vulnerable to experience a great number of dermatological
                       diseases thanks to the intrinsic and extrinsic process of aging.
                       Objectives: The aim of this study is to retrospectively investigate the prevalence of dermatological
                       diseases in geriatric patients, their distribution by age and gender, and to provide a reference for studies
                       on aging and skin problems.
                       Methods: In the present study, patients who reported to the dermatology outpatient clinic between
                       January 1 2019, and January 1 2021, were evaluated retrospectively. As a result of examining the re-
                       cords of patients, 887 patients over the age of 65 who met the study protocol were included.
                       Results: The three most common diseases in all geriatric patients were fungal infections, eczematous
                       dermatitis, and pruritus. Fungal infections were frequent in males and the 65-74 age group. In the males,
                       the more frequent were precancerous lesions and malignant neoplasms, whereas in the females it was ur-
                       ticaria and adverse drug reactions. In the logistic regression model, the risk of fungal infection in geriatric
                       patients was increased by being male (odds ratio 1.55, P = 0.006) and being in the range of 65-74 years
                       old (odds ratio 1.46, P = 0.025). Male patients were at significantly higher risk for precancerous and ma-
                       lignant lesions (OR:2.81 P < 0.001) and actinic keratosis (odds ratio 3.26, P < 0.001) in this disease group.




Original Article | Dermatol Pract Concept. 2022;12(3):e2022145                                                                           1
                      Conclusions: Men are more vulnerable to life-threatening skin diseases. It is important to determine
                      risk factors for individuals who are more sensitive to environmental factors in terms of increasing the
                      quality of life and protection from diseases.




Introduction                                                       Methods
Due to technological advancements and improved living              In this study, patients who reported to the dermatology out-
conditions/standards, life expectancy in Turkey as in other        patient clinic between January 1 2019, and January 1 2021,
parts of the world is increasing on a daily basis. According       were evaluated retrospectively. The records of 887 patients
to the Turkish Statistical Institute, life expectancy at birth     over the age of 65 were examined; 485 (54.7%) of them
increased from 78.0 for the 2013-2015 period to 78.6 for           were females and 402 (45.3%) of them were males.
the 2017-2019 period. Similarly, life expectancy at age 65            The participants were grouped by gender and by age
for both sexes was 17.8 years in the 2013-2015 period, while       groups of 65-74 years and 75 years or older. According to
it was 18 years in the 2017-2019 period [1]. In the last five      the diagnoses, skin diseases and disorders were categorized
years, the proportion of the elderly population, which in-         into 12 groups viral infections, bacterial infections, fungal
cludes individuals aged 65 and over, increased from 8.2%           infections, eczematous dermatitis, papulosquamous diseases,
to 9.5%. It is estimated that the proportion of the elderly        vesiculobullous diseases, precancerous lesions and malignant
population will increase to 11% in 2025, 12.9% in 2030,            neoplasms, benign neoplasms, xerosis cutis, pruritus, urti-
and 16.3% in 2040[(2].                                             caria and adverse drug reactions and other diseases (cuta-
    The geriatric population consists of individuals aged 65       neous lymphomas, pigmentation disorders, connective tissue
and over. Aging is a continuous biological process. During         diseases, vascular diseases, metabolic skin diseases, acne and
the aging process, many functions such as regeneration ca-         related diseases, hair disorders, nail disorders, skin ulcers).
pacity, chemical cleaning capacity, DNA repair capacity,              Data analysis was performed using SPSS 23.0 statistical
sensory perception, mechanical protection and immune re-           program. Descriptive statistical parameters were used for the
sponse of cells forming organs, and tissues decline. Due to        prevalence of skin diseases. Chi-square analysis was used
the effect of these changing cellular functions, the skin struc-   to determine whether there was a significant difference in
ture is adversely affected as in all other organs and systems.     the prevalence of skin diseases according to gender and age
The effects of aging on the skin are evaluated under two           group. A logistic regression model was established for each
different pathways as intrinsic and extrinsic pathways. In-        of the diseases that were significant in the chi-square analy-
trinsic aging is considered the unavoidable and unstoppable        sis. A value of P < 0.05 was accepted as significant in the en-
physiological regression of the functions of cells and tissues.    tire analysis. Ethics committee approval was obtained from
Extrinsic aging on the other hand, is both preventable and         the university ethics committee.
avoidable. It occurs as a result of exposure to environmen-
tal influences such as sunlight and ultraviolet radiation. The
                                                                   Results
effects of extrinsic aging on the skin include not only physi-
ological but also morphological changes. As a result of these      All the 887 patients whose records were examined were
aging mechanisms, there is dryness, wrinkles, flabbiness, and      geriatric patients aged 65 and over. Of these patients, 485
loss of flexibility of the skin and many benign neoplasms          (54.7%) were females and 402 (45.3%) were males. The
also occur in the skin due to aging [3].                           mean age was 73.34 ± 7.24 (65-101) for women, 73.75 ±
                                                                   7.08 (65-94) for men, and 73.53 ± 7.16 (65-101) years for

Objectives                                                         all participants. Five hundred and thirty-nine (60.8%) of
                                                                   the participants were in the age group of 65-74 years and
Due to the physiological and morphological effects of aging        348 (39.2%) were in the age group of 75 years and over. Of
on the skin and the increase in the number of the elderly in       the individuals in the 65-74 age group, 304 (56.4%) were
the population over time, dermatological diseases associated       females and 235 (43.6%) were males. One hundred and
with aging have become an important field of study. The aim        eighty-one (52.0%) of the individuals in the 75 years and
of this study is to retrospectively investigate the prevalence     over age group were females and 167 (48%) were males.
of dermatological diseases in geriatric patients, their distri-       Diseases seen during the entire study period are re-
bution by age and gender, and to provide a reference for           corded as; fungal infections (23.0%), eczematous derma-
studies on aging and skin problems.                                titis (17.1%), pruritus (10.8%), papulosquamous diseases



2                                                                      Original Article | Dermatol Pract Concept. 2022;12(3):e2022145
(8.1%), viral infections (7.8%), precancerous lesions and                   range. Eczematous dermatitis was seen in both sexes; aller-
malignant neoplasms (7.2%), benign neoplasms (5.3%),                        gic contact dermatitis (27.0%), irritant contact dermatitis
xerosis cutis (4.7%), urticaria and adverse drug reactions                  (9.9%), nummular dermatitis (6.6%), lichen simplex chron-
(3.2%), bacterial infections (2.5%), vesiculobullous diseases               icus (6.6%), and erythema intertrigo (3.9%).
(0.9%) and other diseases (9.1%) (Tables 1 and 2).                             Papulosquamous diseases were most common in women
    Fungal infections were most common in men and women                     (60.5%) and men (52.9%) in the 65-74 years group. Papu-
between the ages of 65 and 74, and the incidence in this age                losquamous diseases seen in both sexes; psoriasis Vulgaris
range was between 72.6% and 62.4%. Fungal infections in                     (44.4%), seborrheic dermatitis (37.5%), lichen planus
both sexes; tinea ungium (63.7%), tinea pedis (23.5%), tinea                (11.1%), prurigo nodularis (2.8%), lichen sclerosis et atro-
cruris (5.9%), tinea corporis (5.4%) and candida stomati-                   phicus (2.8%), and parapsoriasis (1.4%).
tis (1.5%).                                                                    Viral infections were more common in women (52.5%)
    Eczematous dermatitis, which is the second most com-                    aged 75 and over, and in men (69.0%) in the 65-74 years
mon dermatologic disease in the geriatric population, was                   age group. Viral infections seen in both sexes; zona zoster
most common in men and women between the ages of 65                         (94.3%), molluscum contagiosum (4.3%) and anogenital
and 74, with a prevalence of 64.4% and 54.8% in this age                    warts caused by human papilloma virus (1.4%).



      Table 1. Distribution of diagnosed skin diseases by gender and results of chi-square analysis
                                        Females               Males                    Total
 Dermatologic Diseases                 N = 495 (%)         N = 402 (%)              N = 887 (%)         P value              X2
 Fungal infections                       95 (19.6)           109 (27.1)              204 (23.0)          0.008              7.032
 Eczematous dermatitis                   90 (18.6)           62 (15.4)               152 (17.1)          0.218              1.520
 Pruritus                                52 (10.7)           44 (10.9)               96 (10.8)           0.915              0.011
 Papulosquamous diseases                  38 (7.8)               34 (8.5)             72 (8.1)           0.735              0.114
 Viral infections                         40 (8.2)               29 (7.2)             69 (7.8)           0.567              0.327
 Precancerous lesions and                 20 (4.1)           44 (10.9)                64 (7.2)          < 0.001            15.278
 malignant neoplasms
 Benign neoplasms                         26 (5.4)               21 (5.2)             47 (5.3)           0.928              0.008
 Xerosis cutis                            28 (5.8)               14 (3.5)             42 (4.7)           0.110              2.557
 Urticaria and Adverse drug               24 (4.9)               4 (1.0)              28 (3.2)           0.001             11.238
 reactions
 Bacterial infections                     11 (2.3)               11 (2.7)             22 (2.5)           0.655              0.199
 Vesiculobullous diseases                 5 (1.0)                3 (0.7)               8 (0.9)           0.655              0.199


   Table 2. Distribution of diagnosed skin diseases by age groups and results of chi-square analysis
                                                            75 years
                                       65-74 years          and over                  Total
 Dermatologic Diseases                 N = 539 (%)         N = 348 (%)             N = 887 (%)          P value              X2
 Fungal infections                      137 (25.4)           67 (19.3)              204 (23.0)           0.033             4.538
 Eczematous dermatitis                   92 (17.1)           60 (17.2)              152 (17.1)           0.947             0.004
 Pruritus                                53 (9.8)            43 (12.4)               96 (10.8)           0.238             1.395
 Papulosquamous diseases                 41 (7.6)                31 (8.9)             72 (8.1)           0.488             0.480
 Viral infections                        39 (7.2)                30 (8.6)             69 (7.8)           0.452             0.565
 Precancerous lesions and                33 (6.1)                31 (8.9)             64 (7.2)           0.117             2.451
 malignant neoplasms
 Benign neoplasms                        34 (6.3)                13 (3.7)             47 (5.3)           0.095             2.789
 Xerosis cutis                           20 (3.7)                22 (6.3)             42 (4.7)           0.074             3.197
 Urticaria and Adverse drug              20 (3.7)                8 (2.3)              28 (3.2)           0.240             1.379
 reactions
 Bacterial infections                    11 (2.0)                11 (3.2)             22 (2.5)           0.295             1.097
 Vesiculobullous diseases                 4 (0.7)                4 (1.1)              8 (0.9)            0.531             0.393



Original Article | Dermatol Pract Concept. 2022;12(3):e2022145                                                                        3
    Precancerous and malignant lesions were most common             countries [4,5]. According to 2020 data, 9.5% of Turkey’s
in women (55%) aged 75 years and above, while in men                population consists of individuals aged 65 and over [6]. In
(54.5%) they were most common in the group of 65-74                 our study, 15% of the total number of patients who reported
years. Precancerous and malignant neoplasms seen in both            to the outpatient clinic were over 65 years old.
sexes; actinous keratosis (78.1%), squamous cell carcinoma              In this study, fungal infections, eczematous dermatitis,
(10.9%), mycosis fungoides (6.3%), basal cell carcinoma             pruritus, papulosquamous diseases, and viral infections in
(3.1%), and lentigo maligna (1.6%).                                 order of the most prevalent to the least, constitute the first
    Benign neoplasms were most common in women                      five most common dermatological diseases groups in the
(69.2%) and men (76.2%) in the 65-74 years age group. Be-           geriatric population. Bilgili et al. In a study conducted in an
nign neoplasms were seen in both sexes; seborrheic keratosis        Eastern city in Turkey where winter conditions are severe,
(27.7%), skin tag (23.4%), epidermal cyst (14.9%), melano-          it is stated that in order of prevalence, the most common
cytic nevus (14.9%) and keloid scar (4.3%).                         dermatological diseases are eczematous dermatitis, fungal
    When the prevalence of skin diseases was analyzed by            infections, pruritus, urticaria-angioedema and bacterial in-
gender; fungal infections (p=0.008) and precancerous and            fections. It is stated that viral infections and papulosqua-
malignant neoplasms (P < 0.001) were more common in                 mous diseases are seen less frequently [7]. In another study
males than females. Among the precancerous and malignant            conducted in Turkey, eczematous dermatitis, pruritus, fungal
neoplasms, actinic keratosis (P < 0.001) was more common            infections, precancerous and malignant lesions, and bacterial
in males than females. When skin diseases were considered           infections are listed as the most common dermatological dis-
according to the distribution among age groups; Fungal in-          eases [8]. When we look at the studies conducted in Turkey
fections were seen more frequently in the 65-74 age group (P        related to the subject of the study, it is seen that the order
= 0.033, significant) compared to the other age group. Tinea        of the most common dermatological disease groups changes
corporis (P = 0.039, significant) among fungal infections and       according to geographical and climatic differences, but it is
allergic contact dermatitis among eczematous dermatitis (P =        seen that eczematous dermatitis, fungal infections, pruritus
0.046, is significant) were seen more frequently in the 65-74       disease group generally ranks high in the studies and main-
age group compared to the other age group (Tables 1 and 2).         tains its significance.
    A logistic regression model was established to analyze the          In this study, fungal infections constitute the most com-
extent to which the parameters with significant differences in      mon disease group in the geriatric population. In addition,
the chi-square test increased the risk of developing skin dis-      fungal infections were 1.55 times more common in men and
eases. According to the established logistic regression model,      1.46 times more common in the 65-74 age group. Similarly,
the risk of fungal infection in geriatric patients was increased    in a study conducted by Yalçın et al in Turkey, fungal in-
by being male (odds ratio [OR] 1.55, P = 0.006) and being in        fections were reported to be more common in males (18%)
the range of 65-74 years old (OR 1.46, P = 0.025). Male pa-         and in the 65-74 years age group (16.7%) [9]. Age, gender,
tients were at significantly higher risk for precancerous and       personal care, epidermal turn-over and decreased immuno-
malignant lesions (OR 2.81, P < 0.001) and actinic keratosis        logical functions may be responsible in the frequent occur-
in this disease group (OR 3.26, P < 0.001) (Table 3).               rence of fungal infections in the geriatric population [10].
                                                                    It is widely accepted that the fact that men are exposed to
                                                                    physical causal factors more than women and that they do
Conclusions
                                                                    not consider skin care as important as women, results in fun-
While the average life expectancy in the world increases on         gal infections being more common in men. This may be the
one hand, on the other hand, efforts to take preventive mea-        reason why the prevalence of this disease was higher in males
sures on the health problems of geriatric patients, provide         in our study too [9].
early diagnosis and necessary medical treatment not only                In this study, eczematous dermatitis constituted the sec-
improve their living conditions, but also reduce costs for          ond most common disease group in the geriatric population.


Table 3. Logistic regression model established for the estimation of risk factors leading to skin diseases
 Dermatologic Diseases           Risk Factor         B             P value           Odds Ratio       95% Confidence Interval
 Fungal infection                    Male          0.442           0.006                 1.555                1.134 - 2.132
                                 65-74 years       0.380           0.025                 1.462                1.050- 2.036
 Precancerous and                    Male          1.036           < 0.001               2.819                1.631 - 4.871
 malignant lesion
 Actinic keratosis                   Male          1.184           < 0.001               3.267                1.735 -6.152



4                                                                       Original Article | Dermatol Pract Concept. 2022;12(3):e2022145
Eczematous dermatitis is more common in the 65-74 years            squamous cell carcinoma and mycosis fungoides in decreas-
age group in both men and women. In addition, among ec-            ing order of prevalence constitute the three most common
zematous dermatitis, contact dermatitis is the most common         lesions. When evaluated as a group, these lesions are 2.81
disorder. Similarly, in the study conducted by Yaldız et al, it    times more frequent in male subjects compared to female
is stated that allergic contact dermatitis (44.5%) and irritant    subjects. In this study, the prevalence of actinic keratosis was
contact dermatitis (33.2%) are the most common diseases            5.6%. In addition, the risk of developing actinic keratosis,
among eczematous dermatitis [4]. The fact that eczematous          which is a common premalignant lesion, is 3.26 times higher
dermatitis is more common in early geriatric ages and con-         in men. Prevalence of actinic keratosis has been reported as
tact dermatitis is more common than others can be explained        29.3% by Kılıç et al, 22.3% by Cvitanovic et al, and 21.1%
by the increased exposure to many environmental and phys-          by Akdeniz et al [16-18]. Likewise, in the study of Akdeniz et
ical extrinsic factors in the development of eczematous der-       al., it was emphasized that actinic keratosis was significantly
matitis. It is thought that it will continue to be seen more       more common in men [18]. Actinic keratosis usually presents
frequently in the coming years due to the changing climatic        as red or brown papules 3-6 mm in diameter on sun-exposed
conditions, increasing exposure to sunlight and increasing         body parts in fair-skinned individuals [19]. The fact that men
chemical exposure.                                                 are exposed to sunlight more frequently in working and so-
    In this study, pruritus was the third most common der-         cial life is acknowledged as one of the important factors that
matological disease. Although it is seen at the same rate          cause it to be more common in men.
in women and men, it is of significance that it is seen at a           The average life expectancy in most of the world is get-
higher rate in the 75 and over age group. Similarly, in a study    ting to continues to increase due to preventive approaches
conducted in Turkey, pruritus (12.8%) was the third most           and improving treatment options. As depend on this condi-
common disease and it was seen to increase from a rate of          tion, geriatric patients take part in the focus of given medical
12.2% in the 65-74 age group, to 14.3% in the 75-84 age            services higher. An important part of the skin problems seen
group, and 16.9% in the 85 and over age group [11]. In a           in geriatric patients are diseases that can be prevented by
study conducted with 46 people staying in a nursing home           protecting individuals against adverse environmental condi-
in Denmark, the pruritus rate was reported as 28.9% [12].          tions. These diseases cause life-threatening conditions albeit
It is acknowledged that the incidence of pruritus increases        at a low rate. It is very important to determine the risk levels
with age. Dry skin, nervous degeneration and weakening of          of individuals in the geriatric population for dermatological
immunity due to aging predispose the aged to pruritus [13].        diseases that adversely affect the quality of life. It can sup-
Among the causes of diseases such as pruritus, it is important     ply to improve the medical services given by dermatologists
to have preventable or intervening measures in order to re-        to geriatrics. We believe that this epidemiological study will
duce this very common disease in later ages. For this reason,      contribute to the dermatologists and clinicians in assessment
it can be said that patient information activities to be carried   and improving preventive approaches to the most seen skin
out in dermatology outpatient clinics and the study of pre-        diseases in geriatric.
ventive medicine by health professionals will be beneficial in
reducing these diseases.
    In this study, papulosquamous diseases was the fourth          References
most common dermatological disease group. In this group of          1. Turkish Statistical Institute (TURKSTAT). Life tables, 2017-2019.
diseases, psoriasis vulgaris, seborrheic dermatitis and lichen         2020. Available from: https://data.tuik.gov.tr/Bulten/Index-
planus, in order of prevalence, are the three most common              ?p=Hayat-Tablolari-2017-2019-33711. Accessed June 25, 2021
diseases. In a study by Darjani et al in Iran, it was reported      2. Turkish Statistical Institute (TURKSTAT). Elderly population statis-
                                                                       tics, 2020. 2021. Available from https://data.tuik.gov.tr/Bulten/In-
that papulosquamosis patients were seen in 31.6% of geriat-
                                                                       dex?p=Istatistiklerle-Yaslilar-2020-37227. Accessed June 25, 2021
ric patients, and seborrheic dermatitis (15.4%) and psoriasis
                                                                    3. Yaar M, Gilchrest BA. Chapter 109: Aging of Skin. In: Goldsmith,
(7.3%) were the first two in this group [14]. In a study by            LA et al (Eds), Fitzpatrick’s Dermatology in General Medicine
Kandwal et al in India, it was reported that papulosquamous            (8th ed.). McGraw-Hill Companies, Inc; 2012. pp:1213-1226.
diseases (40%) and psoriasis (9.4%) as a constituent of this        4. Yaldiz M. Dermatological diseases in the geriatric age group:
group were most common in individuals over 60 years of                 Retrospective analysis of 7092 patients. Geriatr Gerontol Int.
                                                                       2019;19(7):582-585. DOI: 10.1111/ggi.13665. PMID: 30950155.
age [15].
                                                                    5. Berglund AL, Ericsson K. Different meanings of quality of life: a
    In this study, precancerous and malignant lesions were
                                                                       comparison between what elderly persons and geriatric staff be-
seen in 7.2% of the geriatric population. Similar to our study,        lieve is of importance. Int J Nurs Pract. 2003;9(2):112-119. DOI:
the prevalence of precancerous and malignant lesions was re-           10.1046/j.1322-7114.2003.00414.x. PMID: 12694480.
ported as 5.2% by Yalçın et al, 9.6% by Polat et al, and 9.7%       6. Turkish Statistical Institute (TURKSTAT). The Results of Address
by Yaldız et al [4,8,9]. Among these lesions, actinic keratosis,       Based Population Registration System, 2020. 2021. Available




Original Article | Dermatol Pract Concept. 2022;12(3):e2022145                                                                          5
      from: https://data.tuik.gov.tr/Bulten/Index?p=Adrese-Dayali-Nu-      14. Darjani A, Alizadeh N, Rafiei E, et al. Skin Diseases
      fus-Kayit-Sistemi-Sonuclari-2020-37210. Accessed June 25, 2021           among the Old Age Residents in a Nursing Home: A Ne-
 7.   Bilgili SG, Karadag AS, Ozkol HU, Calka O, Akdeniz N. The                glected Problem. Dermatol Res Pract. 2020;2020:8849355.
      prevalence of skin diseases among the geriatric patients in              DOI: 10.1155/2020/8849355. PMID: 33204253. PMCID:
      Eastern Turkey. J Pak Med Assoc. 2012;62(6):535-539. PMID:               PMC7661112.
      22755334.                                                            15. Kandwal M, Jindal R, Chauhan P, Roy S. Skin diseases in geri-
 8.   Polat M, İlhan MN. Dermatological Complaints of the Elderly              atrics and their effect on the quality of life: A hospital-based
      Attending a Dermatology Outpatient Clinic in Turkey: A Pro-              observational study. J Family Med Prim Care. 2020;9(3):1453-
      spective Study over a One-year Period. Acta Dermatovenerol               1458. DOI: 10.4103/jfmpc.jfmpc_1188_19. PMID: 32509632.
      Croat. 2015;23(4):277-281. PMID: 26724880.                               PMCID: PMC7266226.
 9.   Yalçin B, Tamer E, Toy GG, Oztaş P, Hayran M, Alli N. The            16. Kiliç A, Gül U, Aslan E, Soylu S. Dermatological findings in the
      prevalence of skin diseases in the elderly: analysis of 4099             senior population of nursing homes in Turkey. Arch Gerontol
      geriatric patients. Int J Dermatol. 2006;45(6):672-676. DOI:             Geriatr. 2008;47(1):93-98. DOI: 10.1016/j.archger.2007.07.007.
      10.1111/j.1365-4632.2005.02607.x. PMID: 16796625.                        PMID: 17826853.
10.   Özyurt K, Avci A, Çinar SL, Silay E. Dermatological Disorders        17. Cvitanović H, Knezević E, Kuljanac I, Jancić E. Skin disease in a
      in Geriatric Patients. Turk J Dermatol 2014;4:206-209. DOI:              geriatric patients group in outpatient dermatologic clinic Karlo-
      10.4274/tdd.2333.                                                        vac, Croatia. Coll Antropol. 2010;34 Suppl 2:247-251. PMID:
11.   Bas Y, Kalkan G, Seçkin HY, Takci Z, Sahin S, Demir AK. Anal-            21305740.
      ysis of dermatologic problems in geriatric patients: Turkish jour-   18. Akdeniz M, Hahnel E, Ulrich C, Blume-Peytavi U, Kottner J.
      nal of dermatology. Turk J Dermatol. 2014;8(2):95-100.                   Prevalence and associated factors of skin cancer in aged nurs-
12.   12. Dyhre-Petersen N, Gazerani P. Presence and characteristics           ing home residents: A multicenter prevalence study. PLoS One.
      of senile pruritus among Danish elderly living in nursing homes.         2019;14(4):e0215379. DOI: 10.1371/journal.pone.0215379.
      Future Sci OA. 2019;5(6):FSO399. DOI: 10.2144/fsoa-2019-                 PMID: 31009466: PMCID: PMC6476496.
      0036. PMID: 31285844. PMCID: PMC6609920.                             19. Kartal SP, Altunel CT. Premalignant skin tumors. Akgül A (eds).
13.   Valdes-Rodriguez R, Stull C, Yosipovitch G. Chronic pruritus in          Gerontological/65+ Skin and Disorders. First Edition. Ankara:
      the elderly: pathophysiology, diagnosis and management. Drugs            Turkish Clinics; 2019. pp 108-10. Available from: https://
      Aging. 2015;32(3):201-215. DOI: 10.1007/s40266-015-0246-0.               www.turkiyeklinikleri.com/article/en-premalign-deri-tumor-
      PMID: 25693757.                                                          leri-85386.html. Accessed June 28, 2021




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