Contact Dermatitis in Older Adults A Review of the Literature

• Published in: American journal of clinical dermatology Vol. 11; no. 6; pp. 373 - 381
• Main Authors: Prakash, Amy V., Davis, Mark D.P.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2010; Adis International; Wolters Kluwer Health, Inc; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Aging - physiology; Biological and medical sciences; Care and treatment; Contact dermatitis; Demographic aspects; Dermatitis, Allergic Contact - diagnosis; Dermatitis, Allergic Contact - epidemiology; Dermatitis, Allergic Contact - therapy; Dermatitis, Irritant - diagnosis; Dermatitis, Irritant - epidemiology; Dermatitis, Irritant - therapy; Dermatology; Disease Susceptibility; Forecasts and trends; Humans; Immunologic Factors; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Pharmacology/Toxicology; Pharmacotherapy; Review Article; Risk factors; Skin Aging - pathology; Skin Aging - physiology; United States; Pimecrolimus; Bullous Pemphigoid; Dermatitis; Contact Dermatitis; Allergic Contact Dermatitis; Human; Adult; Skin disease; Contact dermatitis; Dermatology; Bibliographic review
• ISSN: 1175-0561; 1179-1888
• DOI: 10.2165/11319290-000000000-00000

Contact dermatitis is a significant health problem affecting the elderly. Impaired epidermal barrier function and delayed cutaneous recovery after insult enhances susceptibility to both irritants and allergens. Exposure to more numerous potential sensitizers and for greater durations influences the rate of allergic contact dermatitis in this population.Medical co-morbidities, including stasis dermatitis and venous ulcerations, further exacerbate this clinical picture. However, while these factors tend to increase the degree of sensitization in the elderly, waning immunity can actually decrease such a propensity. This interplay of both intrinsic and extrinsic factors makes a generalization on trends for contact dermatitis in older adults challenging. The literature has varying reports on the overall incidence of allergic contact dermatitis with advancing age. Nevertheless, it does clearly show that sensitivity to topical medicaments increases with age. Irritant contact dermatitis studies are more consistent, with less reactivity (to irritants) in older compared with younger skin. Diagnosis of both irritant and allergic contact dermatitis is based on a thorough history, complete skin examination, and comprehensive patch testing. The mainstay of therapy is avoidance of the offending chemical substances and the use of topical along with systemic therapies, depending on the severity of the condition.