Skin Problems In The Elderly II
Non-Cancerous Skin Growths
Fig.1 Seborrheic keratosis
The elderly can develop many benign skin growths of different types. These include seborrheic keratoses Fig.1 (which are rough, brownish-black spots), cherry angiomas (smooth reddish bumps) and sebaceous hyperplasia (yellow bumps consisting of oil glands).
Benign skin growths do not need treatment but cancerous growth should be removed early to prevent spread to other parts of the body. If in doubt always consult a doctor. Your dermatologist can advise you whether your skin growths are likely to be benign or cancerous.
Cancerous Skin Growths
Fig.2 Solar keratosis
Fig.3 Basal cell carcinoma
Fig.4 Squamous cell carcinoma
Those elderly persons who had extensive sun exposure earlier in their life might develop pre-cancerous skin growths called solar keratoses Fig.2 and skin cancers like basal cell carcinomas and squamous cell carcinomas. Basal cell carcinomas and squamous cell carcinomas most commonly appear on the face. They start as small bumps and gradually enlarge, until they ulcerate. They can be pink or black in colour. See your doctor if you have any enlarging skin growth or a non-healing sore.
There are several types of skin cancers. The commonest is called basal cell carcinoma Fig.3 which appears as a small shiny growth with a central ulcer or depression. This is a slow growing cancer.
Another type of cancer is squamous cell carcinoma Fig.4. They appear as red scaly patches or pinkish growths. Sometimes they can be very large and raised.
Cancerous moles are less common but they tend to spread quickly if not treated. They appear as moles with irregular borders, irregular colours and lopsided shapes.
If you are not sure whether the growths are skin cancers, see your doctor. All cancers must be removed.
Adverse Drug Reaction
As the elderly tend to be receiving multiple drugs for various medical problems, they are more likely to develop adverse reactions to drugs Fig.5. The most common adverse reaction to drugs is seen in the skin, where it can present as red, itchy rashes or blisters. It is important that such rashes be recognised early so that the offending drug can be discontinued, thereby preventing the damage caused by the drug from becoming too serious. It is important to ,keep a record of the medications, prescribed or not, that you take. Be sure to bring all medications when you consult you-r doctor.
Fig.5 Adverse reaction to drugs
Some elderly persons have poor blood circulation in the legs, leading to rashes around the ankles called stasis dermatitis Fig.6. Untreated, this might lead to skin ulcers.
Fig.6 Stasis dermatitis
What are the special skin care needs of the elderly?
The elderly require special skin care because their skin is thin and dry. Care must be taken to prevent the skin from becoming too dry. Hot baths should be avoided. Avoid frequent bath/shower. Avoid soap or at most a mild soap should be used. If the skin is dry, moisturisers should be applied on the skin after bath.
As the skin becomes dry, cracks appear. Bacteria enters the skin easily to cause skin infection.
Those who are bedridden need to avoid prolonged pressure on the ankles, heels and buttock. Too much pressure can tear the thin skin leading to bed sores.
DEDICATED TO EXCELLENCE IN DERMATOLOGY
By National Skin Centre (Singapore)
Copyright (C) 1995 - National Skin Centre (Singapore)