Dermatology, National Skin Centre, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
J Eur Acad Dermatol Venereol. 2022 Sep;36(9):1648-1659. doi: 10.1111/jdv.18205. Epub 2022 May 24.
Populations around the world are rapidly ageing. The profile of skin diseases in the elderly is likely to present unique demands on the healthcare system.
To provide current data on the burden of skin diseases in Singaporean patients and identify differences in the pattern of skin diseases between elderly patients and the rest of the population.
This was a retrospective cohort study of 858 117 patients who attended the National Skin Centre between 2004 and 2018. Prevalence was calculated by grouping International Classification of Diseases codes into different categories of skin conditions based on Global Burden of Disease and American Academy of Dermatology classifications. Years lost to disability (YLDs) and disability-adjusted life years (DALYs) were calculated to report the morbidity and mortality of skin diseases. Differences of each skin condition between age groups were compared.
The three most prevalent dermatoses across all age groups were dermatitis (33.3%), acne vulgaris (8.3%) and viral skin diseases (7.5%). The top three most common skin conditions among the elderly were dermatitis (37.7%), viral skin diseases (6.2%) and fungal skin diseases (4.3%). Decubitus ulcers, keratinocyte carcinomas and scabies represented a significant proportion of YLD per 100 000 in the elderly (P < 0.001). Malignant melanomas, keratinocyte carcinomas, cellulitis, pyoderma and decubitus ulcers contributed to high DALYs in patients aged 70-80 years.
Aligning health systems with specific healthcare needs will reduce the disproportionately high burden of skin disease observed in the elderly.
全球人口正在迅速老龄化。老年人的皮肤病谱可能对医疗保健系统提出独特的要求。
提供新加坡患者皮肤病负担的最新数据，并确定老年患者与其他人群之间皮肤病发病模式的差异。
这是一项对 2004 年至 2018 年期间在国家皮肤中心就诊的 858117 例患者进行的回顾性队列研究。根据全球疾病负担和美国皮肤病学会的分类，将国际疾病分类代码分组为不同类别的皮肤病，计算患病率。计算伤残损失年（YLDs）和残疾调整生命年（DALYs），以报告皮肤病的发病率和死亡率。比较了不同年龄组之间每种皮肤病的差异。
所有年龄段最常见的三种皮肤病是皮炎（33.3%）、寻常痤疮（8.3%）和病毒性皮肤病（7.5%）。老年人中最常见的三种皮肤病是皮炎（37.7%）、病毒性皮肤病（6.2%）和真菌性皮肤病（4.3%）。压疮、角质形成细胞癌和疥疮在老年人每 10 万人中 YLD 所占比例较高（P<0.001）。70-80 岁患者的黑色素瘤、角质形成细胞癌、蜂窝织炎、脓疱病和压疮导致高 DALYs。
使卫生系统与特定的医疗保健需求保持一致将降低老年人中观察到的不成比例的高皮肤病负担。
