LTC Bookshelf - "Skin Diseases in the Elderly"

As the population ages, there is an increasing need for geriatricians to be informed on skin conditions that affect the elderly. In “Skin Diseases in the Elderly: A Color Handbook,” Colby Craig Evans, MD, and Whitney A. High, MD, discuss skin conditions that are specific to the elderly, including testing, diagnosis, and treatment options. Inflammatory, neoplastic, infectious, metabolic, and nutritional skin diseases are covered in depth and illustrated by more than 200 color photographs. Annals of Long-Term Care® (ALTC) had the opportunity to interview Evans about the resources provided in the new handbook.

ALTC: Would you describe your handbook as being more accessible for a general audience of healthcare providers?

Evans: Yes. The intended audience of the book is primary care providers, including geriatricians, internal medicine physicians, physician assistants, and nurse practitioners. The book is written to be comprehensive but easy to use in a clinical setting. It features not only advice in making dermatologic diagnoses in the elderly, but also guidelines for treatment and referrals. We intend our book to be useful on an everyday basis in clinical settings.

What are some of the challenges to treating skin diseases in the elderly?

There are many challenges to treating skin disease in the elderly, and the introduction to the book reviews each specifically. Difficulty applying topical medications, increased risk of medication side effects, polypharmacy, and increased risk of skin cancer (and some other skin diseases) with age are all issues especially important in the elderly population. Each chapter of our book focuses on treatment recommendations specifically for the elderly patient and provides tips and ideas for diagnosis and treatment.  

The handbook includes a chapter on detecting skin signs of systemic disease in old age. Why did you feel this was an important addition to the handbook?

The skin usually reflects overall health and can often be the presenting sign of certain cancers, diabetes, and many other conditions that are more common in the elderly. A skin examination may help the geriatrician detect early or subtle systemic diagnoses along with primary skin conditions. The skin is also particularly easy to biopsy (compared to the internal organs) and so may allow a systemic diagnosis to be made more safely and easily. Our book also highlights the normal signs of skin aging to contrast them with disease states. We hope that it will help guide geriatricians and primary care providers in not only providing excellent skin care but also using the skin as a window to other problems associated with aging.

“Skin Diseases in the Elderly: A Color Handbook” was published in October 2011 by Manson Publishing, London, UK.