PREVALENCE AND CUTANEOUS MANIFESTATIONS OF SKIN DISORDERS AMONG ELDERLY PATIENTS ATTENDING A DERMATOLOGY OUTPATIENT DEPARTMENT: A HOSPITAL-BASED CROSS-SECTIONAL STUDY

Abstract

Background: The global and Indian populations are ageing rapidly, and age-related decline in skin-barrier function, immunosenescence and a rising burden of chronic disease make cutaneous disorders exceptionally common among older adults. Contemporary region-specific data describing the pattern of geriatric dermatoses in South India remain limited. Objectives: To determine the prevalence of skin disorders among elderly patients (aged >=60 years) attending a dermatology outpatient department in South India, to characterise the spectrum and clinical manifestations of these disorders, and to describe the accompanying comorbidity, polypharmacy and risk-factor profile. Methods: This hospital-based cross-sectional study analysed 300 consecutive patients aged >=60 years attending a tertiary-care dermatology outpatient service. Each patient underwent a complete dermatological examination; data on demographics, diagnosis, body site, morphology, severity, symptoms, comorbidities, polypharmacy, risk factors and diagnostic basis were recorded on a structured proforma. Descriptive statistics were computed and associations tested using the chi-square test, with p < 0.05 considered significant.  Results: The mean age was 71.7 years (SD 7.4; range 60-84) with a male predominance (168; 56.0%; M:F 1.27:1). At least one skin disorder was present in 246 of 300 patients (82.0%). Xerosis was the single commonest diagnosis (46; 15.3%), followed by fungal infection (44; 14.7%) and eczematous dermatitis (40; 13.3%). Infective dermatoses collectively (fungal, bacterial, viral and scabies) formed the largest disease category, affecting 90 patients (30.0%). The lower limb was the commonest site and dry scaling the commonest morphology; pruritus (58.1%) was the dominant symptom, and the mean lesion duration was 186.7 days. The population carried a heavy burden of hypertension (58.7%), polypharmacy (>=5 drugs; 50.3%) and diabetes mellitus (43.3%). Diabetes was not significantly associated with the presence of any skin disorder (chi-square = 0.11, p = 0.74). Conclusion: A very high proportion (82.0%) of elderly dermatology attendees had at least one skin disorder, typically of long duration. Xerosis was the commonest specific diagnosis and infective dermatoses the largest category, against a background of substantial comorbidity and polypharmacy. The findings support dedicated geriatric-dermatology services, emollient and skin-care education, and attention to polypharmacy in South India.