Skip to main content
Top
Published in: Drugs & Aging 5/2019

01-05-2019 | Allergic Contact Dermatitis | Review Article

Contact Dermatitis in the Elderly: Predisposing Factors, Diagnosis, and Management

Authors: Ana Luiza Lima, Vanessa Timmermann, Tanja Illing, Peter Elsner

Published in: Drugs & Aging | Issue 5/2019

Login to get access

Abstract

Increased aging of the general population is a well-known fact with serious effects on health systems worldwide. Skin aging involves various immunological and structural changes that increase the risk of numerous skin diseases such as contact dermatitis. Contact dermatitis is characterized by an inflammation of the skin caused by an interaction between the skin and external agents and is divided into irritant and allergic contact dermatitis. Irritant contact dermatitis occurs on skin areas directly exposed to irritant substances, which results in a stream of pro-inflammatory cytokines mediating the skin injury. Asteatotic and perineal irritant contact dermatitis are the most important subtypes of irritant contact dermatitis in the elderly. Allergic contact dermatitis is a T cell-mediated inflammatory reaction and requires a prior sensitization. The most common allergens responsible for allergic contact dermatitis in the elderly are fragrance mix, nickel, and balsam of Peru. Elderly patients with stasis dermatitis, chronic wounds, and chronic venous insufficiency have an increased prevalence of sensitization due to the frequent exposure to topical treatments. In this review, the most common types of contact dermatitis in the elderly are enumerated in order to assist dermatologists and other physicians to identify contact dermatitis in this distinct group of the population.
Literature
3.
go back to reference Wiegand C, Raschke C, Elsner P. Skin aging: a brief summary of characteristic changes. Textbook of aging skin. Berlin/Heidelberg: Springer-Verlag; 2015. Wiegand C, Raschke C, Elsner P. Skin aging: a brief summary of characteristic changes. Textbook of aging skin. Berlin/Heidelberg: Springer-Verlag; 2015.
4.
go back to reference Lukacs J, Elsner P. Irritant contact dermatitis. Textbook of aging skin. Berlin/Heidelberg: Springer-Verlag; 2015. Lukacs J, Elsner P. Irritant contact dermatitis. Textbook of aging skin. Berlin/Heidelberg: Springer-Verlag; 2015.
7.
go back to reference Wenisch C, Patruta S, Daxbock F, Krause R, Horl W. Effect of age on human neutrophil function. J Leukoc Biol. 2000;67(1):40–5.CrossRefPubMed Wenisch C, Patruta S, Daxbock F, Krause R, Horl W. Effect of age on human neutrophil function. J Leukoc Biol. 2000;67(1):40–5.CrossRefPubMed
16.
go back to reference Thune P, Nilsen T, Hanstad IK, Gustavsen T, Lovig Dahl H. The water barrier function of the skin in relation to the water content of stratum corneum, pH and skin lipids. The effect of alkaline soap and syndet on dry skin in elderly, non-atopic patients. Acta Derm Venereol. 1988;68(4):277–83. Thune P, Nilsen T, Hanstad IK, Gustavsen T, Lovig Dahl H. The water barrier function of the skin in relation to the water content of stratum corneum, pH and skin lipids. The effect of alkaline soap and syndet on dry skin in elderly, non-atopic patients. Acta Derm Venereol. 1988;68(4):277–83.
17.
go back to reference Elsner P, Wilhelm D, Maibach HI. Sodium lauryl sulfate-induced irritant contact dermatitis in vulvar and forearm skin of premenopausal and postmenopausal women. J Am Acad Dermatol. 1990;23(4 Pt 1):648–52.CrossRefPubMed Elsner P, Wilhelm D, Maibach HI. Sodium lauryl sulfate-induced irritant contact dermatitis in vulvar and forearm skin of premenopausal and postmenopausal women. J Am Acad Dermatol. 1990;23(4 Pt 1):648–52.CrossRefPubMed
18.
go back to reference Harvell JD, Maibach HI. Percutaneous absorption and inflammation in aged skin: a review. J Am Acad Dermatol. 1994;31(6):1015–21.CrossRefPubMed Harvell JD, Maibach HI. Percutaneous absorption and inflammation in aged skin: a review. J Am Acad Dermatol. 1994;31(6):1015–21.CrossRefPubMed
20.
go back to reference Fenske NA, Lober CW. Structural and functional changes of normal aging skin. J Am Acad Dermatol. 1986;15(4 Pt 1):571–85.CrossRefPubMed Fenske NA, Lober CW. Structural and functional changes of normal aging skin. J Am Acad Dermatol. 1986;15(4 Pt 1):571–85.CrossRefPubMed
21.
go back to reference Yaar M, Gilchrest BA. Skin aging: postulated mechanisms and consequent changes in structure and function. Clin Geriatr Med. 2001;17(4):617–30 (v). Yaar M, Gilchrest BA. Skin aging: postulated mechanisms and consequent changes in structure and function. Clin Geriatr Med. 2001;17(4):617–30 (v).
30.
32.
go back to reference Fluhr JW, Dickel H, Kuss O, Weyher I, Diepgen TL, Berardesca E. Impact of anatomical location on barrier recovery, surface pH and stratum corneum hydration after acute barrier disruption. Br J Dermatol. 2002;146(5):770–6.CrossRefPubMed Fluhr JW, Dickel H, Kuss O, Weyher I, Diepgen TL, Berardesca E. Impact of anatomical location on barrier recovery, surface pH and stratum corneum hydration after acute barrier disruption. Br J Dermatol. 2002;146(5):770–6.CrossRefPubMed
36.
go back to reference Wilhelm KP, Maibach HI. Factors predisposing to cutaneous irritation. Dermatol Clin. 1990;8(1):17–22.CrossRefPubMed Wilhelm KP, Maibach HI. Factors predisposing to cutaneous irritation. Dermatol Clin. 1990;8(1):17–22.CrossRefPubMed
38.
go back to reference Krasteva M, Kehren J, Ducluzeau MT, Sayag M, Cacciapuoti M, Akiba H et al. Contact dermatitis I. Pathophysiology of contact sensitivity. Eur J Dermatol. 1999;9(1):65–77. Krasteva M, Kehren J, Ducluzeau MT, Sayag M, Cacciapuoti M, Akiba H et al. Contact dermatitis I. Pathophysiology of contact sensitivity. Eur J Dermatol. 1999;9(1):65–77.
40.
go back to reference Buckley DA, Rycroft RJ, White IR, McFadden JP. The frequency of fragrance allergy in patch-tested patients increases with their age. Br J Dermatol. 2003;149(5):986–9.CrossRefPubMed Buckley DA, Rycroft RJ, White IR, McFadden JP. The frequency of fragrance allergy in patch-tested patients increases with their age. Br J Dermatol. 2003;149(5):986–9.CrossRefPubMed
42.
go back to reference Wohrl S, Hemmer W, Focke M, Gotz M, Jarisch R. Patch testing in children, adults, and the elderly: influence of age and sex on sensitization patterns. Pediatr Dermatol. 2003;20(2):119–23.CrossRefPubMed Wohrl S, Hemmer W, Focke M, Gotz M, Jarisch R. Patch testing in children, adults, and the elderly: influence of age and sex on sensitization patterns. Pediatr Dermatol. 2003;20(2):119–23.CrossRefPubMed
43.
go back to reference Piaserico S, Larese F, Recchia GP, Corradin MT, Scardigli F, Gennaro F, et al. Allergic contact sensitivity in elderly patients. Aging Clin Exp Res. 2004;16(3):221–5.CrossRefPubMed Piaserico S, Larese F, Recchia GP, Corradin MT, Scardigli F, Gennaro F, et al. Allergic contact sensitivity in elderly patients. Aging Clin Exp Res. 2004;16(3):221–5.CrossRefPubMed
44.
go back to reference Balato A, Balato N, Di Costanzo L, Ayala F. Contact sensitization of older patients in an academic department in Naples. Italy. Dermatitis. 2008;19(4):209–12.CrossRef Balato A, Balato N, Di Costanzo L, Ayala F. Contact sensitization of older patients in an academic department in Naples. Italy. Dermatitis. 2008;19(4):209–12.CrossRef
46.
go back to reference Wakelin SH, Smith H, White IR, Rycroft RJ, McFadden JP. A retrospective analysis of contact allergy to lanolin. Br J Dermatol. 2001;145(1):28–31.CrossRefPubMed Wakelin SH, Smith H, White IR, Rycroft RJ, McFadden JP. A retrospective analysis of contact allergy to lanolin. Br J Dermatol. 2001;145(1):28–31.CrossRefPubMed
47.
go back to reference Bordel-Gomez MT, Miranda-Romero A. Contact sensitization to Euxyl K-400. Actas Dermosifiliogr. 2009;100(3):201–4.CrossRefPubMed Bordel-Gomez MT, Miranda-Romero A. Contact sensitization to Euxyl K-400. Actas Dermosifiliogr. 2009;100(3):201–4.CrossRefPubMed
48.
go back to reference Tennvall GR, Andersson K, Bjellerup M, Hjelmgren J, Oien R. [Treatment of venous leg ulcers can be better and cheaper. Annual costs calculation based on an inquiry study]. Lakartidningen. 2004;101(17):1506–10, 12–3. Tennvall GR, Andersson K, Bjellerup M, Hjelmgren J, Oien R. [Treatment of venous leg ulcers can be better and cheaper. Annual costs calculation based on an inquiry study]. Lakartidningen. 2004;101(17):1506–10, 12–3.
Metadata
Title
Contact Dermatitis in the Elderly: Predisposing Factors, Diagnosis, and Management
Authors
Ana Luiza Lima
Vanessa Timmermann
Tanja Illing
Peter Elsner
Publication date
01-05-2019
Publisher
Springer International Publishing
Published in
Drugs & Aging / Issue 5/2019
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI
https://doi.org/10.1007/s40266-019-00641-4

Other articles of this Issue 5/2019

Drugs & Aging 5/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine