In view of the demographic development, the importance of skin diseases in geriatric patients is increasing in everyday practice. A study by a German research team analyzed data from patients over 65 years of age who had been hospitalized at a dermatology clinic. It was found that malignant neoplasms of the skin and malignant cutaneous melanomas were the most common reasons for hospitalization.
In Western Europe, the number of elderly (≥65 years) and very elderly (≥90 years) patients is expected to increase as the “baby boomer generation” reaches geriatric age. However, there are still large gaps in knowledge regarding this increasingly important group of patients. In a retrospective monocentric study, data were collected from hospitalized patients over 65 years of age who had been hospitalized at the Department of Dermatology, University Hospital Freiburg (D), during the period 2009-2017 [1].
A total of 10,009 geriatric hospitalizations were confirmed during this period, of which 5346 patients were hospitalized once and 1148 patients were hospitalized twice or more. The most frequently coded dermatologic diagnoses (Table 1) included malignant neoplasms of the skin (basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma; ICD-10, C44) malignant melanoma of the skin (ICD-10, C43) and varicose veins of the lower extremities (ICD-10, I83). These study data were published in the journal Archives of Dermatological Research 2022.
Age gradient of malignant neoplasms of the skin
Subgroup analysis showed that the number of patients treated for non-melanocytic skin cancer (NMSC) and Merkel cell carcinoma (MCC) increased significantly with age: 31% vs. 60.1% in patients aged 65-74 vs. over 95 years (p<0.01). The observation that the three most common diagnoses in men are NMSC of different locations confirms their increased risk for cutaneous malignancies [2,3]. Possible reasons include occupational factors, UV exposure, and sunscreen [4–7]. Female patients were also frequently hospitalized for venous problems with ulceration or dermatitis. In the cohort of those over 95 years of age, a shift toward diseases associated with significant quality-of-life impairment if untreated, such as progressively enlarged NMSC or pemphigoid disease associated with infection, pain, and bleeding, was noted, while fewer patients were registered for inflammatory diseases such as atopic dermatitis. Mohs surgery, dressings, and multimodality dermatologic treatments were the most frequently coded therapeutic procedures.
Literature:
- Ansorge C, Miocic JM & Schauer F: Arch Dermatol Res 2022; 314: 427-437.
- Hauschild A, et al: JDDG 2013; 11(s3): 10-15.
- Stratigos A, et al: Eur J Cancer 2015; 51(14): 1989-2007.
- Clark LN, et al: J Am Acad Dermatol 2007; 56(5): 768-773.
- Subramaniam P, et al: Aust JAMA Dermatol 2017; 153(2): 175-182.
- Chevalier V, et al: Br J Dermatol 2014; 171(3): 595-601.
- Görig T, et al: JEADV 2018; 32(2): 225-235.
DERMATOLOGIE PRAXIS 2023; 33(1): 34
