Skin pathology findings in a cohort of 1500 adult and elderly subjects

Background No extensive studies are available in the literature on the even tual skin pathology induced by neurologic or systemic diseases in elderly i ndividuals. Other factors, such as health and hygiene,socioeconomic status, and climate can also play an important role. Methods Fifteen-hundred subjects (886 women and 614 men; mean age, 67.8 yea rs; range, 39-90 years) were admitted to the Department of Geriatrics at th e Oasi Institute between 1992 and 1997; all these subjects were carefully e valuated from a dermatologic point of view. Each subject underwent speciali st examinations, routine blood analyses, thoracic X-rays, cerebral computer ized tomography (CT) scan, and magnetic resonance imaging (MRI) when approp riate. A group of subjects without significant neurologic or systemic disea se, comprising 116 women and 60 men (mean age, 64.5 years; range, range, 40 -90 years), was selected and used as a normal control group. Subsequently, our attention was focused on the eventual presence of the following neurolo gic diseases: Alzheimer-type dementia, vascular dementia, mixed-type dement ia, subcortical dementia, Parkinson's disease, vascular brain disease, hemi plegia, etc. Thus, different subgroups were formed on the basis of such dia gnostic categories and the frequency of skin pathology in each subgroup was evaluated. Results Of the 1500 subjects, 1439 stated that they had never been affected by dermatologic disease. No statistically significant difference in freque ncy of skin pathology was found between normal controls and the different p atient subgroups. Unsuspected and singular dermatoses were found, however, such as paraneoplastic syndromes, idiopathic tripe palms, white fibrous pap ulosis of the neck as an expression of photoaging, conditions induced by fo rmer popular traditions of Sicilian culture (anetoderma secondary to the ap plication of Hirudo medicinalis and erythema ab igne), pigmented dermatoses never described before in Italy (prurigo pigmentosa and friction amyloidos is), and nail abnormalities (atypical half-and-half nail, and dyschromic na il changes in multiple system atrophy and in hemiplegia). Conclusions The dermatologic screening performed in 1500 patients revealed several unexpected diagnoses and some original observations. Some rare derm atoses were described and certain hypotheses were suggested to explain the peculiar dyschromic changes of the fingernails in multiple system atrophy, the atypical cases of half-and-half nail, and the so-called idiopathic trip e palms associated with psoriasis.