Cutaneous mycoses in the elderly

S20-3

Aging

and skin care

0. Fyrand. Dep of Demratology. Rikshospitalet,

N-0027,

Oslo,

The National Nonvay

Hospital,

Aging is a continous process, but the skin after 40 years may be defined as “aged”. The two sexes treat their skin differently, based upon biological and sociocultural aspects within rational and metaphysical dimensions. This makes it difficult to know whether we are treating our skin or our psyche. Men have a different skin than women. Higher levels of testosteron results among others in more active sebaceous glands. The male role is defined more according to their social situation, combined with a more wetherbeaten and rough outlook. Females are judged differently and are valued more according to their looks. Skin care can be judged according to daily routines, dry skin, antiaging. reconstructive and metaphysical aspects and treatments. Some of these will be highlighted. ElS20 4 Diseases of genital K.L. Dalziel. University Hospital, Nottingham,

skin in the elderly Queen

s Medical

Centre,

1S20-6

Diseases

of the hair and scalp in the elderly

GE. PiCrard, C. PiCrard-Franchimont. LiPge, Belgium Ageing manifests itself on the scalp where it may affect the skin and the hair cycle, structure and pigmentation. There is evidence that both chronological ageing and photoageing are deleterious to the hair density. In addition, metabolic deficiencies prevailing in the elderly show additive impact on such aspect. Heliodermatosis and epithelial neoplasms may be severe particularly when androgenic alopecia is of long duration. Other neoplasms such as angiosarcoma and atypical fibro-xanthoma are also found with predilection on the scalp in the elderly.

UK

Genital skin disease in the elderly is common and often poorly managed due to embarrassment on the part of the patient, and referral to specialists who do not recognise skin diseases. If not identified, disorders such as seborrhoeic eczema and contact irritant and allergic dermatitis can lead to decades of itching and scratching. Lichen sclerosus and erosive lichen planus are both commoner in the elderly. In addition to causing severe symptoms, these diseases should be diagnosed and treated because of their pre-malignant potential. Several of the immuno-bullous disorders preferentially involve genital skin and mucosa. Cicatricial pemphigoid, pemphigus vulgaris and pemphigus vegetans may all present in these sites. Pain syndromes are not uncommon in the vulva1 area and dysaesthetic vulvodynia is most often a disease of the elderly, with significant morbidity. Recognition and management of genital disease in the elderly can greatly improve quality of life and may reduce the risk of scarring and malignant change in some conditions. S20-5 1 Changes

in the nail plate of the elderly

A.Y. Finlay. Dept Dermatol, CF4 4XN,

secondary bacterial infection. Benign and malignant tumours can alter nail plate, in particular myxoid cysts affecting the fingernails are more common in this age range where arthritis of the distal interphalangeal joints is more prevalent. The nail plate changes associated with old age have economic implications in that chiropody services and systemic therapy may be required to maintain health and reduce the incidence of secondary complications.

Univ

Wales

Coll Med.

Caniig

UK

Abnormalities of the nails are very common in the elderly. The reasons include physiological changes, increased incidence of disease and increasing difficulty with appropriate nail care because of infirmity or other disease. Problems associated with these changes may have significant influence on mobility or on fine use of the fingers and so add to the difficulties of adapting to old age. The physiological changes include variations in nail plate thickness, changes in contour and decreased linear growth; it is possible that some of these changes may be influenced by reduced local blood supply. The incidence of fungal infection damaging nail plate is much greater in the elderly; this may lead to other problems such as discomfort and

mycoses in the elderly IIIS20 7 Cutaneous Isaak Effendy. Department of Dermatology, University Marburg,

of

Germane

Apart from the presence and virulence of the organism, host defences play a crucial role in the pathogenesis of fungal infection. In the elderly, however, several factors are often found, which favor the origin of cutaneous mycoses. Obesity, circulatory disorders, confinement to bed, changed personal hygiene are frequent predisposing factors. Moreover, treatments with corticosteroids, immunsupressiva, cytostatica, which may often be performed in the elderly, allowing in turns organism to invade the skin or mucous membranes. This review will give brief proposals for diagnostic and treatment for cutaneous mycoses depending on the clinical features. Since the population of the elderly has been increased, the prevention of mycoses should be given more attention.

s21. S21-1

Oral disorders Behcet’s

disease

and complex

aphthosis

Joseph L. Jorizzo. Professor

and Chais Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, Telephone: (336) 716-2768, Fax: (336) 716-7732, USA

Behcet’s disease is a complex multisystem disease diagnosed using clinical criteria in the absence of a pathognomonic laboratory test. Problems exist with each existing set of criteria. Clinical features include: oral and genital aphthae, pustular vasculitic cutaneous lesions, and ocular, synovial, neurologic and vascular manifestations. Cutaneous lesions include: cutaneous small vessel vasculitis, pustular vasculitis, pathergy, and lesions which resemble the following: erythema nodosum. Sweet’s