Iän tuomat iho-ongelmat

Abstract

<div lang="fi" class="abs"><p class="abs_header">Tiivistelmä</p><p>Ikääntyminen aiheuttaa rakenteellisia ja toiminnallisia muutoksia eri elimiin, myös ihoon. Monien ihosairauksien esiintyvyys kasvaa ikääntyessä (1). Nykyiselläänkin ihotaudit aiheuttavat kuolemaan johtamattomista sairauksista neljänneksi eniten tautitaakkaa sairauden vuoksi menetettyinä toimintakykyisinä elinvuosina mitaten (disability adjusted life years, DALY) (2). Väestön vanhetessa tämä taakka lisääntyy.</p><p>Väestötason tutkimuksia ikäihmisten ihosairauksien yleisyydestä on niukasti. Noin 4 000 potilaan sairaalarekisteristä tehdyn tutkimuksen mukaan yleisimpiä olivat ekseemat, ihoinfektiot, kutina ja ihosyövät (3). Myös hyvänlaatuisten ihokasvainten, kuten seborrooisten keratoosien (rasvaluomien), kirsikkaluomien ja lentigojen, määrä lisääntyy iän karttuessa (4).</p><p>Tässä katsauksessa käsittelemme tavanomaisia iän tuomia iho-ongelmia. Krooniset alaraajahaavat sekä lääkeaineihottumat on jätetty katsauksesta pois.</p></div>

<div lang="en" class="abs"><p class="abs_header">Abstract</p><p>Skin problems in the elderly</p><p>Aging causes many structural changes in the skin and affects its functionality. Therefore, many skin diseases are more common in the older population. Measured on the DALY index (disability adjusted life years), skin diseases are the fourth most common disease group causing disability. The most common skin diseases in older adults are eczemas, skin infections, pruritus and malignant diseases. Skin aging can be divided into chronological aging and photoaging. Smoking, air pollutants and exposure to ultraviolet radiation are the most significant factors in skin aging.</p><p>Dry skin is the most common cause of pruritus in the elderly but sometimes systemic diseases can be the cause and they must be excluded. Asteatotic eczema is a common skin disease found particularly in the elderly population. It is caused by structural changes in the skin and excessive washing with soap. It can be prevented by applying moisturizing cream daily. Sometimes corticosteroid creams or ultraviolet light treatment are needed. Seborrhoeic dermatitis is most common in older people and possibly caused by a weakened immune system. As many as half of the elderly population are estimated to have dermatitis in skinfolds. The term MASD (moistureassociatedskin damage) is used when moisture and chemicals break the skin’s protective barrier. It is treated with washing and careful drying of the skinfolds. Sometimes local antimycotics are needed because of secondary infection. Skin infections caused by bacteria, viruses and fungi are common in the elderly because of their weakened immune system.</p><p>Malignant and premalignant lesions are becoming more common due to aging of the population. The prevalence of actinic keratosis varies according to age, skin phototype and residence. Some actinic keratoses evolve to Bowen’s disease and eventually to squamous cell carcinoma. Diagnosis is confirmed by biopsy. Actinic keratoses with mild dysplasia can be treated topically. Otherwise treatment by a dermatologist is needed. Patients’ ability to function must be considered when treating older patients.</p></div>