University of Geneva, Geneva, Switzerland.
Département Exploration Cutanée, Centre de Recherche sur la Peau, Pierre Fabre Dermo-Cosmetique, Toulouse, France.
J Eur Acad Dermatol Venereol. 2017 Aug;31(8):1380-1386. doi: 10.1111/jdv.14240. Epub 2017 May 2.
The term dermatoporosis has been proposed to describe clinical signs and functional consequences of age-related extreme skin fragility.
To create a simple dermatoporosis self-diagnosis tool (IDA: Index Dermatoporosis Assessment) and to use this tool to estimate the prevalence of dermatoporosis in France.
DESIGN, SETTING AND PARTICIPANTS: A specific dermatoporosis questionnaire was developed with the help of senior dermatologists and survey experts. This questionnaire was submitted to consecutive individuals aged ≥65 years who consulted a dermatologist. At the end of the consultation, the dermatologist was asked to assess 'whether or not' dermatoporosis was present. In a second step, the final questionnaire was mailed to a representative sample of the French population aged ≥65 years in order to estimate the prevalence of dermatoporosis.
The initial questionnaire, consisting of two modules (24 questions), was validated in 173 individuals aged ≥65 years) during a dermatologist consultation. Dermatologists diagnosed 46% of the individuals with dermatoporosis. The final validated questionnaire consisted of 14 items, 12 consisting in presence or absence of clinical signs and two items consisting of the self-assessment by individuals of skin ageing on neckline and hands (none/moderate/significant/very significant). A scoring system was generated to quote quantitatively dermatoporosis (from 0 if no sign of dermatoporosis to 20 maximal dermatoporosis). The area under the receiver operator curve was 0.8535, indicating a very good ability of the questionnaire to differentiate between individuals. A cut-off value of 11 was linked to positive and negative predictive values of 0.78 and 0.81, respectively. In a second step, using the questionnaire in a representative sample of the French population (n = 533), the estimated overall prevalence of dermatoporosis was 37.5% in French subjects aged ≥65 years [27.5% (males) vs. 43.9% (females); P < 0.05]. The estimated prevalence of dermatoporosis was twice higher in subjects with eczema or atopic dermatitis during childhood than in the population without dermatoporosis (60.6% vs. 33.4%, P < 0.001). Individuals with dermatoporosis also reported a higher prevalence of itching, long-term corticosteroid use, anticoagulant use and prior sun exposure.
Using a new simple dermatoporosis self-diagnosis tool, this study provides a previously unprecedented insight into the high prevalence of dermatoporosis in elderly individuals. IDA questionnaire is a short (14-item) and easy to use tool for evaluating dermatoporosis in adults and may allow an easy evaluation of each subject.
已经提出了“皮肤疏松症”这一术语，以描述与年龄相关的极度皮肤脆弱的临床体征和功能后果。
创建一个简单的皮肤疏松症自我诊断工具（IDA：皮肤疏松症评估指数），并使用该工具估计法国皮肤疏松症的患病率。
设计、设置和参与者：在资深皮肤科医生和调查专家的帮助下，开发了一种特定的皮肤疏松症问卷。该问卷提交给了咨询皮肤科医生的连续年龄≥65 岁的个体。在咨询结束时，皮肤科医生被要求评估“是否”存在皮肤疏松症。在第二步中，向年龄≥65 岁的法国代表性人群邮寄最终问卷，以估计皮肤疏松症的患病率。
最初的问卷由两个模块（24 个问题）组成，在 173 名年龄≥65 岁的个体的皮肤科医生咨询中进行了验证。皮肤科医生诊断出 46%的个体患有皮肤疏松症。最终验证后的问卷由 14 个项目组成，其中 12 个项目是临床体征的存在或缺失，另外 2 个项目是个体对颈部和手部皮肤老化的自我评估（无/中度/明显/非常明显）。生成了一个评分系统，以定量评估皮肤疏松症（无皮肤疏松症为 0，最大皮肤疏松症为 20）。受试者工作特征曲线下的面积为 0.8535，表明问卷区分个体的能力非常好。11 分的截断值与 0.78 和 0.81 的阳性和阴性预测值相关。在第二步中，在法国人口的代表性样本（n=533）中使用该问卷，估计≥65 岁的法国人群中皮肤疏松症的总患病率为 37.5%[男性为 27.5%（男性）与女性为 43.9%（女性）；P<0.05]。在儿童时期患有湿疹或特应性皮炎的人群中，皮肤疏松症的估计患病率是没有皮肤疏松症人群的两倍（60.6%对 33.4%，P<0.001）。皮肤疏松症患者还报告了更高的瘙痒、长期使用皮质类固醇、使用抗凝剂和既往暴露于阳光下的患病率。
使用新的简单皮肤疏松症自我诊断工具，本研究首次深入了解了老年人中皮肤疏松症的高患病率。IDA 问卷是一种简短（14 项）且易于使用的成人皮肤疏松症评估工具，可用于评估个体。
