Department of Dermatology, Allergology and Venereology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
J Eur Acad Dermatol Venereol. 2019 Feb;33(2):447-450. doi: 10.1111/jdv.15240. Epub 2018 Oct 1.
Dermatoporosis describes the cutaneous signs and complications related to chronic cutaneous fragility related to ageing, chronic sun exposure and long-term use of topical and systemic corticosteroids. Chronic renal failure may be an additional cofactor. The prevalence of dermatoporosis is estimated around 32-37% in France among the elderly.
We evaluated the prevalence of dermatoporosis and its risk factors in outpatients who attended a consultation in the department of dermatology of Helsinki University Central Hospital.
A prospective observational study of 176 consecutive outpatients aged 60 years and older, who attended a consultation in the department of dermatology of Helsinki University Central Hospital. Data collection included age, gender, reason for consultation, local or systemic corticosteroid therapy, antiplatelet drugs and anticoagulant therapy, diabetes and chronic kidney failure (glomerular filtration rate < 60 mL/min/m ). The presence of dermatoporosis, location on the body and staging were collected.
30.7% presented dermatoporosis. Lesions were mainly located on the upper limbs (94%), and stage I was the most frequent (75.9% of the cases). Multivariate analysis revealed that dermatoporosis was significantly associated with ultrapotent topical corticosteroids (odds ratio (OR) 5.34, 95% CI 1.85-15.43, P = 0.002), oral corticosteroids (OR 3.22, 95% CI 1.18-8.80, P = 0.022), concomitant corticosteroid therapy, anticoagulant and chronic renal failure (OR 4.02, 95% CI 1.34-12.01, P = 0.013) and age (OR 1.05, 95% CI 1.01-1.10, P = 0.016). Patients with bullous pemphigoid were those with the highest prevalence of dermatoporosis in our cohort (64%).
Acknowledging the selection bias in our study, the prevalence of dermatoporosis in a dermatology consultation in Finland seems as frequent as in France. These results prompt us to weigh the indications of long-term corticosteroids use in frail elderly patients.
皮肤疏松症是指与衰老、慢性阳光暴露和长期使用局部和全身皮质类固醇相关的慢性皮肤脆弱性相关的皮肤表现和并发症。慢性肾衰竭可能是另一个共同的因素。据估计，法国老年人中皮肤疏松症的患病率约为 32-37%。
我们评估了在赫尔辛基大学中央医院皮肤科就诊的门诊患者中皮肤疏松症的患病率及其危险因素。
对在赫尔辛基大学中央医院皮肤科就诊的 176 例连续门诊患者进行前瞻性观察性研究。收集的数据包括年龄、性别、就诊原因、局部或全身皮质类固醇治疗、抗血小板药物和抗凝治疗、糖尿病和慢性肾衰竭（肾小球滤过率<60mL/min/m）。收集皮肤疏松症的存在、身体部位和分期。
30.7%的患者存在皮肤疏松症。病变主要位于上肢（94%），最常见的是 I 期（75.9%的病例）。多变量分析显示，皮肤疏松症与超强效局部皮质类固醇（比值比[OR]5.34，95%可信区间[CI]1.85-15.43，P=0.002）、口服皮质类固醇（OR 3.22，95%CI 1.18-8.80，P=0.022）、同时使用皮质类固醇治疗、抗凝和慢性肾衰竭（OR 4.02，95%CI 1.34-12.01，P=0.013）和年龄（OR 1.05，95%CI 1.01-1.10，P=0.016）显著相关。在我们的队列中，大疱性类天疱疮患者皮肤疏松症的患病率最高（64%）。
考虑到我们研究中的选择偏倚，芬兰皮肤科门诊中皮肤疏松症的患病率与法国相似。这些结果促使我们权衡在体弱的老年患者中长期使用皮质类固醇的适应证。
