Maintaining Health of the Largest Human Organ: Focus on Skin

The focus of this issue is on our largest and most visible organ, the skin. In this era of preventive medicine, it seems easy to tell our patients how to prevent skin problems: just stay out of the sun! However, the importance of sun exposure and vitamin D levels is becoming more and more apparent. Epidemiological evidence showing inverse relationships between multiple sclerosis and sun exposure has been available for years, and more recent evidence suggests that sun exposure may protect against juvenile (type I) diabetes mellitus. In adult populations, vitamin D may be important in preventing various neoplasias, and among older adults, it is protective against falls. It seems that once again, the more I learn the less I seem to know for sure. In any event, this month’s issue will provide lots of opportunity for useful learning. Our CME article this month is on “Common Skin Conditions among Older Adults in Long-Term Care” by Dr. Foy White-Chu and Dr. Madhuri Reddy. We have an article on “Older Adults and Burns” by Dr. Joel Fish and Dr. Kristen Davidge, and then in recognition of how much we value our looks, we have an article on “Facial Rejuvenation in the Aging Population” by Dr. Jeffrey Fialkov. As well, our cancer column this month is on a cutaneous malignancy, namely “Malignant Melanoma among Older Adults” by Drs. Wey Leong, Alexandra Easson and Michael Reedijk.

As well, we have our usual collection of articles on other important topics concerning older adults. “The Role of Peripheral Arterial Disease in the Pathogenesis of Diabetic Foot Disease: When to Refer for Vascular Surger” is by Dr. Robert Hinchcliffe and Dr. William Jeffcoate and provides practical advice to the primary care physician. Our Dementia column this month looks at “Dementia Related to Alcohol and Other Drugs” and is by Dr. Kiran Rabheru. Decubitus ulcers are a major health care problem among older adults, with multiple factors involved in their etiology and pathogenesis. A major factor is discussed in the article “The Role of Nutrition in the Prevention and Management of Pressure Ulcers” by Zena Moore and Dr. Seamus Cowman. As our population of patients with end-stage renal disease ages, the population undergoing transplantation is also aging. Combined with the prolonged survival that many patients currently experience after transplantation, we are seeing many more older renal transplant recipients. Some of the issues these patients present with are discussed in the article “Primary Care Issues in Renal Transplant Recipients” by Dr. Jeffery Schiff.

Enjoy this issue,
Barry Goldlist