Clinical consequences of age-related skin barrier dysfunction. Part II. Approach to barrier dysfunction in the geriatric population.

Aging is associated with significant changes to skin structure and function which lead to distinct clinical needs in geriatric dermatology patients. By understanding the relationship between altered skin function with aging and the clinical implications for geriatric dermatology patients, dermatologists can guide patients in developing a preventive regimen and managing age-related skin pathology. The second article of this 2-part continuing medical education series reviews the most common conditions affecting geriatric dermatology patients and specific treatment considerations with a focus on the impact of age-related skin barrier dysfunction.

Clinical consequences of age-related skin barrier dysfunction. Part I. Structural, molecular and physiologic changes with cutaneous aging.

Aging is associated with significant changes to skin structure and function. As the United States population ages, dermatologists are increasingly presented with the clinical consequences of these changes. Understanding the biology of aging skin allows dermatologists to best guide patients towards proactive treatment of age-related skin disease. The first article of this 2-part continuing medical education series reviews the structural, molecular and functional changes associated with skin aging.

A Case of Atypical Lymphocytic Lobular Panniculitis.

Atypical lymphocytic lobular panniculitis (ALLP) is a rare T-cell dyscrasia of the subcutaneous fat. It typically presents with indurated erythematous nodules on the lower extremities and often will have a relapsing and remitting course. The cause is unknown, but clinically and histopathologically it shares similarities to lupus panniculitis (LP) and subcutaneous panniculitis-like T-cell lymphoma (SPTCL). It generally has an indolent course, and may best be treated like indolent versions of SPTCL with systemic steroids and immunosuppressive medications.

Hidradenitis Suppurativa in a Patient with Smith-Magenis Syndrome: A Case Report.

Hidradenitis suppurativa (HS) is an inflammatory disorder characterized by recurrent painful nodules and draining sinus tracts with subsequent scarring. HS has been associated with several dermatologic syndromes including the follicular occlusion tetrad, PASH (pyoderma gangrenosum, acne, and suppurativa hidradenitis), PAPASH (pyogenic arthritis, pyoderma gangrenosum, acne, and suppurativa hidradenitis), and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndromes. However, aside from the well-established association between HS and Down Syndrome, it has rarely been reported in association with other multisystem genetic diseases. We report a case of HS in a 22-year-old man with Smith-Magenis syndrome (SMS), a developmental disorder caused by a chromosomal 17 microdeletion. Obesity and a tendency toward follicular occlusion are features of SMS that may have contributed to the development of HS in our patient. Interestingly, the patient also had several other follicular-based skin diseases including erythromelanosis follicularis faciei, keratosis pilaris, and acne keloidalis nuchae. Dermatologic findings in SMS have been characterized in the literature in the past, but to our knowledge, this is the first case of HS reported in a patient with SMS. We also provide a brief literature review of cases of HS occurring in patients with other multisystem genetic diseases.

Psoriasis and comorbidities: links and risks.

Psoriasis is a chronic inflammatory skin disease affecting approximately 2% of the population worldwide. In the past decade, many studies have drawn attention to comorbid conditions in psoriasis. This literature review examines the epidemiological evidence, pathophysiological commonalities, and therapeutic implications for different comorbidities of psoriasis. Cardiovascular disease, obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome, nonalcoholic fatty liver disease, cancer, anxiety and depression, and inflammatory bowel disease have been found at a higher prevalence in psoriasis patients compared to the general population. Because of the wide range of comorbid conditions associated with psoriasis, comprehensive screening and treatment must be implemented to most effectively manage psoriasis patients.