Factores asociados a dermatoporosis en una muestra de pacientes geriátricos en México / Factors associated with dermatoporosis in a sample of geriatric patients in Mexico

Resumen Introducción: La dermatoporosis es un síndrome crónico de fragilidad cutánea, caracterizado por atrofia, púrpura y pseudocicatrices en piel. Objetivo: Determinar los factores asociados a dermatoporosis en una muestra de sujetos ≥ 60 años. Métodos: Estudio observacional, transversal, descriptivo y analítico de sujetos ≥ 60 años a quienes se realizó historia clínica, exploración física y aplicación de un autocuestionario diagnóstico de dermatoporosis. Para determinar los factores asociados se realizó análisis de regresión logística multivariado. Resultados: En 315 sujetos, la prevalencia de dermatoporosis fue de 29 %; 70 % fue del sexo femenino. Los factores asociados fueron edad > 75 años (p = 0.001), exposición solar prolongada (p = 0.002), ingesta de anticoagulantes/antiplaquetarios (p = 0.004), esteroides orales (p = 0.03) y enfermedad renal crónica (p = 0.03); así como, edad materna > 40 años en el último parto (p = 0.02), lactancia > 7 meses por embarazo y lactancia acumulada > 18 meses (p = 0.01). Se relacionaron con su ausencia, edad < 20 años en el primer embarazo y menopausia después de los 45 años. La correlación entre la autovaloración y el diagnóstico clínico fue muy alta (0.95, p < 0.001). Conclusiones: Los factores de riesgo asociados a dermatoporosis fueron similares a los previamente reportados.

Abstract Introduction: Dermatoporosis is a chronic cutaneous fragility syndrome, characterized by skin atrophy, purpura and pseudo-cicatrices. Objective: To determine factors associated with dermatoporosis in a sample of subjects aged ≥ 60 years. Methods: Observational, cross-sectional, descriptive, analytical study of subjects aged ≥ 60 years who underwent history taking, physical examination and application of a self-administered dermatoporosis diagnostic questionnaire. To determine the associated factors, a multivariate logistic regression analysis was used. Results: In 315 evaluated subjects, the prevalence of dermatoporosis was 29%; 70% were females. Associated risk factors were age > 75 years (p = 0.001), prolonged sun exposure (p = 0.002), use of anticoagulants/antiplatelet medications (p = 0.004), oral steroids (p = 0.03) and chronic kidney disease (p = 0.03); as well maternal age > 40 years at last pregnancy (p = 0.02), breastfeeding for > 7 months per pregnancy and > 18 cumulative months (p = 0.01). Age < 20 years at first pregnancy and menopause after 45 years were related to dermatoporosis absence. The correlation between self-assessment and clinical diagnosis was considerably high (0.95, p < 0.001). Conclusions: The risk factors associated with dermatoporosis were similar to those previously reported.

Therapeutic Effect of 1% Pimecrolimus for the Treatment of Senile Purpura / 대한피부과학회지

BACKGROUND: Senile purpura is characterized by ecchymoses on the extensor surfaces of the forearms and the dorsa of hands in the elderly. The prevalence is around 10% in the eight and ninth decades. Its occurrence is secondary to the fragility of blood vessel walls caused by atrophy of dermal collagen bundles and solar elastosis due to intrinsic aging and photoaging. For prevention of senile purpura, sunscreens and barrier protection should be used. However, there has been no specific medical treatments developed for senile purpura. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy of a topical calcineurin inhibitor for the treatment of senile purpura. METHODS: Seven patients with senile purpura applied 1% pimecrolimus cream twice daily for 2 weeks. Efficacy was evaluated by the subject's assessment and by the objective findings using photographic assessment. RESULTS: There was an 8.5% reduction in the purpuric area compared with the initial lesion. When the Wilcoxon signed-rank test was used for determination of the purpuric area between the pre-treatment condition and the post-treatment condition, the therapeutic effect was statistically significant (p=0.004). Three of seven patients (42.9%) were satisfied with their treatment, and four of them (57.1%) were neither satisfied nor dissatisfied. No adverse events were observed during the treatment and follow up periods. CONCLUSION: This study shows that 1% pimecrolimus cream can be an effective and safe treatment modality for senile purpura.