GERIATRICS INTEGUMENTARY

CHRONOLOGICAL OR INTRINSIC AGING

PHYSIOLOGIC CHANGES IN AGING

• Refers to those changes considered to be due only to the passage of time and is caused by internal factors related to degeneration of physiologic processes, such as diminished collagen synthesis.

Example:

• Characterized by thinness and reduction in elasticity resulting to wrinkles formation but are usually very fine and thus appears relatively smooth.

EXTRINSIC AGING

PHYSIOLOGIC CHANGES IN AGING

• Result of chronic exposure of the skin to external factors such as smoking, poor nutrition and especially UV lights, which induces photoaging.

Example:

• Characterized as deep wrinkles, sagging and a leathery appearance

age 18

the human body reaches full anatomic and physiologic maturity

PRIME OF LIFE

The peak years of physiologic function last from the late teens through the thirties

50s to 60’s

these physiologic changes become more apparent

Beyond 70’s

they are significant and no longer deniable

INTEGUMENTARY SYSTEM

Consist of the skin and its accessory structures including hair, nails, and the sweat and sebaceous glands

Age related changes in the epidermis and dermis

• Thin Epidermis (slower repair function)

• Dry Epidermis (reduction in sebaceous and sweat gland)

• Fewer melanocytes (Paler skin)

• Thin Dermis (sagging, wrinkles)

• Reduced sweat gland activity (tendency to overheat)

• Reduced blood supply (slower healing)

• Changes in distribution of fat and hair (reduction in sex hormones)

• Fewer active follicles (thinner, sparse hair)

Senile Lentigo

EXPECTED AGE-RELATED CHANGES

Are often referred to as age spots or liver spots due sun exposure.

Seborrheic keratosis

EXPECTED AGE-RELATED CHANGES

slightly raised, wartlike macules with distinct edges appear

Cutaneous papilloma (skin tags)

EXPECTED AGE-RELATED CHANGES

Are small, brown or flesh- colored projections of skin and most often observed on the necks

Crow’s feet (Lateral Canthal lines)

EXPECTED AGE-RELATED CHANGES

Are fine lines that form on the outer corners of your eyes

Pigment loss and Hair distribution patterns change.

EXPECTED AGE-RELATED CHANGES

Fingernails

EXPECTED AGE-RELATED CHANGES

grow more slowly, may become thick and more brittle, and ridges or lines

Toenails

EXPECTED AGE-RELATED CHANGES

may become so thick.

Sweat gland function decreases

Decreased perspiration results to heat intolerance.

Melanoma

COMMON DISORDERS SEEN WITH AGING

• The most dangerous skin cancer

• Resembles a splotchy brown patch with uneven borders

• Nodular _____ appears as a brown or red raised spot

Basal Cell Carcinoma

COMMON DISORDERS SEEN WITH AGING

• Most common form of skin cancer

• Most particularly dangerous

• Appears similar to a red mole or sore

Squamous Cell Carcinoma

COMMON DISORDERS SEEN WITH AGING

• Appears as a scaly spot that is crusty

• Not as serious as melanoma, but can spread quickly if left untreated

Pressure Ulcers

COMMON DISORDERS SEEN WITH AGING

• Breakdown of skin and tissues located over bony prominences.

STAGE 1 ULCER

Pressure Ulcers

Non-Blanching Erythema, with intact Epidermis

STAGE 2 ULCER

Pressure Ulcers

Partial Thickness Ulcer involving Epidermis & Dermis

STAGE 3 ULCER

Pressure Ulcers

Full Thickness Ulcer extending through Dermis in to Subcutaneous tissue

STAGE 4 ULCER

Pressure Ulcers

Deep Tissue Destruction extending through Fascia & may involve muscle bone & tendons

Rosacea

INFLAMMATION

appears as redness, dilated superficial blood vessels, and small “pimples” on the nose and center of the face

Contact and Atopic Dermatitis

COMMON DISORDERS SEEN WITH AGING

• appear as rashes or inflammation that is either localized to certain areas of the body or generalized.

• Lesions are symmetrical and more severe in the periorbital region

Seborrheic Dermatitis

COMMON DISORDERS SEEN WITH AGING

is an unsightly skin condition characterized by yellow, waxy crusts that can be either dry or moist

Shingles

COMMON DISORDERS SEEN WITH AGING

• INFECTION (virus)

• poses particular dangers.

• painful rash

• single stripe of blisters

• It can lead to disabling complications, and increase the chance of conditions like dementia, stroke, and heart disease.

Scabies

COMMON DISORDERS SEEN WITH AGING

• INFECTION (parasitic, mites)

• Elderly individuals may be at a higher risk of developing scabies than others

• intense itching (especially at night)

• and a red rash or tiny burrows on the skin

Onychomycoses

COMMON DISORDERS SEEN WITH AGING

• INFECTION (fungal)

• caused by dermatophytes, yeasts, and non-dermatophyte molds

• infection of the nail plate, nail bed, or both.

• The nails typically are deformed and discolored white or yellow.

Hypothermia

COMMON DISORDERS SEEN WITH AGING

The decrease in subcutaneous tissue reduces the older adult’s ability to regulate body temperature.