Common Disorders Seen with Aging
Basal Cell Carcinoma and Melanoma
It is important to distinguish normally occurring changes in the skin from lesions that may be precancerous or cancerous. Cases of basal cell carcinoma are commonly observed in older adults who have spent significant amounts of time in the sun. By age 70 approximately 20% of white, non-Hispanic men have developed a non-melanoma cancer. Male senior citizens are also most at risk for melanoma, a potentially deadly form of skin cancer due to its ability to metastasize. In 2009 more than 8,000 deaths were attributed to melanoma.
Pressure Ulcers
Shrinkage in the cushion provided by subcutaneous tissue along with vascular changes places the older adult at increased risk for pressure ulcers (i.e., breakdown of the skin and tissues located over bony prominences) . This is a significant problem for immobilized people such as those who are bedridden or confined to wheelchairs.
Pressure ulcers, Early-stage pressure ulcers, or stage I lesions, are commonly dismissed as minor abrasions because their primary attribute is nonblanchable erythema, Stage II ulcer, which is characterized by some skin loss, may be difficult to identify accurately because of its resemblance to a blister or abrasion.
Inflammation and Infection
Changes in the integumentary system increase the older adult’s risk for skin inflammation and infection. Skin inflammation and infection often occur on visible surfaces of the body such as the face, scalp, and arms, making the conditions distressing to the older adult.
Common types of inflammation include rosacea and various forms of dermatitis. Rosacea appears as redness, dilated superficial blood vessels, and small “pimples” on the nose and center of the face It may spread to cover the cheeks and chin. Left untreated, it can lead to swelling and the enlargement of the nose or to conjunctivitis. There is no known cause for this disorder, but it is most common in postmenopausal women, people who flush easily, and individuals taking vasodilation medications. Treatment of vasodilation includes lifestyle modification such as avoidance of triggers such as stressful situations, extreme heat, sun exposure, spicy foods, and alcoholic beverages. In addition oral and topical medications or light and laser treatments may provide some benefits
Several forms of dermatitis are common in older adults, including contact, allergic, and seborrheic dermatitis. Contact and allergic dermatitis appear as rashes or inflammation that is either localized to certain areas of the body.
Seborrheic dermatitis is an unsightly skin condition characterized by yellow, waxy crusts that can be either dry or moist excessive sebum production, seborrheic dermatitis can occur on the scalp, eyebrows, eyelids, ears, axilla, breasts, groin, and gluteal folds. There is no known cure, but treatment with special shampoos and lotions helps control the problem.
Infectious diseases of the skin and nails commonly seen in older adults include herpes zoster (also called shingles); fungal, yeast, and bacterial infections; and infestation with scabies (mites). Each of these diseases has a unique cause, characteristic appearance, and specific treatment that are beyond the scope of this text.
Hypothermia
The decrease in the amount of subcutaneous tissue reduces the older adult’s ability to regulate body temperature. Very thin older adults lose the insulation provided by subcutaneous and adipose tissue. This loss of insulation is most likely to result in hypothermia if the person is exposed to an environment that is too cold.
PREVENTION
The elderly who lives alone should be encouraged to use heaters, extra clothing and extra blankets at night. The room temperature should be maintained at 21 degrees.
Hot water bottle are an alternative frequent warm drink and hot food rather than cold can help during the day.
