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Skin Disease in the Older Adult

Botox parties to get rid of wrinkles. Facelifts to look better and ensure success in our youth-obsessed society. Tragic deaths from lipectomy or breast suspensions reported in the popular press. If the eyes are the mirror of our soul, perhaps our skin is the mirror of our vanity. The incredible increase in demand for cosmetic surgery often makes us forget that the skin is our largest organ, and in many ways our most important. It is our barrier against the outside world, and life is impossible without that protective layer. Problems with skin (except, perhaps, for youthful acne) tend to increase with advancing age, and cosmetic issues are only one aspect of these changes. Some of these changes are truly age related, but many are secondary to sun exposure. We decrease our chances of skin malignancy and save money otherwise allocated to cosmetic surgery simply by limiting our direct exposure to the sun. Interestingly enough, the desire to look healthy and tanned is a modern phenomenon, popularized in western culture by Coco Chanel in the early 20th century. Before that, evidence of sun exposure indicated that you were part of the working class, and sun exposure was avoided.

I am very pleased that this issue has a focus on skin disease, and that we have so many excellent articles. Gordon Searles discusses “Benign Pigmented Lesions in Older Adults,” while Drs. Wong and Shear have contributed the second part of their article on “Cutaneous Adverse Drug Reactions in Older Adults.” Our senior editor, D’Arcy Little, contributes with a “Review of the Diagnosis and Management of Fungal Skin and Nail Infections.”

As well, we have our usual stellar collection of articles on other key topics. Michelle Ghert and Peter Ferguson discuss “Primary Bone and Soft Tissue Tumours in the Geriatric Population,” while Colin Barry and Marino Labinaz discuss “Coronary Revascularization in Older Adults.” Mohammed Al-Omran and Yaron Sternbach present a detailed review of “Lower Limbs Critical Ischemia.” Questions have always arisen about the clinical importance of the outcomes of cholinesterase inhibitor trials in Alzheimer’s Disease. Serge Gauthier addresses this topic in his article entitled “Efficacy of Donepezil on Maintenance of Activities of Daily Living in patients with Moderate-to-Severe Alzheimer’s Disease.” Nobody can argue about maintaining ADLs as a valid and important outcome measure in dementia. As well, we hope you take the time to participate in our CME, based on the informative contribution from Drs. Anu Singhal, Ernane Reis, and Morris Kerstein on “Pressure Ulcers: Etiology, Treatment, and Prevention,” which was featured Geriatrics & Aging’s February issue.

Enjoy this issue.