Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland.
University Hospital, Kraków, Poland.
Folia Med Cracov. 2023 Jul 30;63(2):29-40. doi: 10.24425/fmc.2023.145911.
Atopic dermatitis (AD) is a chronic, recurrent inflammatory dermatosis. The most characteristic symptoms of the disease include itch, eczematous eruptions and excessive dryness of the skin. Elderly patients with AD represent a poorly characterized population because the physiological ageing, possible comorbidity and polypharmacy modify the clinical presentation typically observed in the younger age groups. The aim of the study is to comprehensively assess the clinical characteristics of elderly patients (>60 years old) with AD. Data were collected from 26 AD patients treated in the Department of Dermatology of the University Hospital in Krakow. Late-onset AD with generalized/prurigo lesions was the most predominant phenotype. Skin biopsy was required in 15 (58%) patients in the differential diagnosis process. Allergic rhinitis, a positive family history of atopy and xerosis were associated with a higher number of hospitalizations during the year prior to the last admission (p = 0.034, p = 0.046 and p = 0.036, respectively). Xerosis was more prevalent among subjects with polypharmacy (p = 0.046) and higher serum total IgE concentration (p = 0.048). AD in elderly patients is a new phenotype of the disease that requires careful differential diagnosis. Aged patients with an individual or family history of atopy, due to the increased incidence of severe exacerbations of AD, may benefit from the introduction of proactive therapy.
特应性皮炎(AD)是一种慢性、复发性炎症性皮肤病。该病最典型的症状包括瘙痒、湿疹样皮疹和皮肤过度干燥。老年 AD 患者是一个特征描述较差的人群,因为生理衰老、可能的合并症和多种药物治疗改变了在年轻人群中观察到的典型临床表现。本研究的目的是全面评估老年 AD 患者(>60 岁)的临床特征。数据来自于在克拉科夫大学医院皮肤科接受治疗的 26 名 AD 患者。迟发性 AD 伴全身性/痒疹样病变是最主要的表型。在鉴别诊断过程中,15 名(58%)患者需要进行皮肤活检。变应性鼻炎、特应性家族史和皮肤干燥与上一次入院前一年的住院次数增加相关(p = 0.034、p = 0.046 和 p = 0.036)。皮肤干燥在多药治疗的患者中更为普遍(p = 0.046)和血清总 IgE 浓度较高的患者中更为普遍(p = 0.048)。老年 AD 患者是一种新的疾病表型,需要仔细进行鉴别诊断。有特应性个人或家族史的老年患者,由于 AD 严重恶化的发生率增加,可能受益于主动治疗的引入。