The skin fulfills one of its most important functions, that is protection from mechanical injuries, due to the mechanism of reversible deformation of the structure. Human skin is a complex living material but in biomechanical tests it reveals its homogeneous nature. Biomechanical skin parameters change with time. Results of thickness measurements, where the skin was subjected to pressure, revealed that the Young's modulus increased linearly with age. The process of ageing is the reason why the skin becomes thinner, stiffer, less tense and less flexible. Skin tension measured during in vivo uniaxial load and the elasticity modulus are higher in children than in elderly adults. Furthermore, mean ultimate skin deformation before bursting is 75% for newborns and 60% for the elderly. Several types of the main lines were distinguished on the skin. The static lines, described by Langer, correspond to the lines of maximum tension, the Kraissl's lines correspond to the movements of the skin during muscle work, whereas the Borges lines are the relaxed skin tension lines. Biomechanical tests of the human skin help to quantify the effectiveness of dermatological products, detect skin diseases, schedule and plan surgical and dermatological interventions and treatments.

No abstract

Genital psoriasis is a variety of autoimmune dermatological disease -psoriasis with relapsing-remitting course, which can have an onset in all age groups. It is most often diagnosed at an advanced stage. Genital psoriasis is considered an embarrassing condition and is often misjudged as a sexually transmitted disease or allergic reaction due to low social awareness of the disease. The manifestations of genital psoriasis may differ from typical genital dermatoses and with symptoms such as itch, erythroderma and vaginal discharge may mimic other diseases at an early stage. The diagnosis and treatment of genital psoriasis may be difficult and often requires a multidisciplinary approach. The aim of this article is to present the literature review of genital psoriasis concentrating on the clinical presentation, treatment and influence on the quality of patients' life and sexual activity disorders.

BackgroundFalling in the elderly results in a significant number of admissions to hospitals and long-term care facilities, especially among patients with lower extremity osteoarthritis (OA).ObjectiveThe aim of the study was to assess the risk of falling in adults older than 60 years with OA using timed up and go (TUG) test.Materials and methodsA total of 187 patients (aged >60 years) were enrolled in the study. The assessment included: basic activities of daily living (ADLs), lower extremity strength with the use of the 30-second chair stand test (30 CST), and assessment of the risk of falling (TUG test). Pain intensity was evaluated with the numeric rating scale (NRS).ResultsThe TUG test results were significantly better in younger OA patients (aged 60–69 years), as compared with their older peers (aged 70–79 years; P<0.01) and the oldest group (aged >80 years; P<0.001). Also, the 30 CST results were significantly higher in younger OA patients (P<0.05). Subjects older than 80 years had a significantly worse ADL score (P<0.05 and P<0.001). Pain complaints were reported significantly more frequently by women than men (P<0.05). A correlation between age and the TUG test score (r=0.412; P<0.0004) as well as between the TUG test and the 30 CST scores (r=0.7368; P=0.000) was detected. In the group with the TUG test score of <13.5 seconds, the 30 CST (P<0.0001) and ADL (P<0.003) results were significantly better. A comparison of fallers vs nonfallers revealed that the number of falls was significantly higher in the group of subjects who scored ≥13.5 when compared to <13.5 (P=0.003). Fallers significantly more often reported pain (P<0.0001), whereas nonfallers had significantly better 30 CST results (P=0.0003).ConclusionElderly population with OA is at an elevated risk of falling, which increases with progressing age, pain, and muscle weakness. It seems prudent to identify individuals at a high risk of falling and to propose an adequate treatment for them.

BackgroundPsychological stress is an important factor of acne pathogenesis. Stress related production of hormones, cytokines and neuropeptides may result in the chronic course and exacerbations of the disease.ObjectiveThe aim of the study was to evaluate the relationship between acne severity, intensity of emotional stress and serum concentration of substance P (scSP), to compare the intensity of adversities, psychological stress and scSP in acne patients with healthy controls and to compare coping techniques for stress.MethodsThe study consisted of 80 patients. Emotional stress was analyzed with the use of social readjustment rating scale, whereas the methods of coping with stress were assessed with the coping inventory for stressful situation questionnaire. The blood concentration of substance P was analyzed by enzyme-linked immunosorbent assay method in a group of 40 patients with acne vulgaris and in control subjects.ResultsThere was no statistically significant difference between the severity of acne and the intensity of stress. Acne patients presented a higher average scSP than the controls. No statistically significant correlation was observed between the severity of acne and scSP; however, the intensity of stress correlated with scSP in the control group. The evaluation of methods of coping with stress showed significantly higher rate for the avoidance-oriented coping among acne patients.ConclusionThe number of stressful events is not a factor that determines the severity of acne. The course of the disease may depend on tolerance to stress and methods of coping with stress.

Background: Depression remains an important health problem among older adults and it may be correlated with the deterioration of physical fitness, whose chief indicator is hand grip strength (HGS). The aim of the study was to investigate the relationship between depression and HGS among older populations using the available literature. Methods: PubMed, Web of Science and Science Direct databases were searched. The inclusion criteria were as follows: written in English and published after 2009, subject age: ≥60 years, HGS measured using a hand dynamometer, assessment of the depressive symptoms using a validated tool. The following articles were excluded: studies conducted among institutionalized subjects and/or populations with a specific disease. Results: The total combined effect of 33 results presented in 16 studies included in the meta-analysis, converted to the correlation coefficient, was OEr = −0.148 (SE = 0.030, 95%CI: −0.206–−0.091), indicating a weak, negative correlation between HGS and depressive symptoms. Conclusions: The review of the literature and the meta-analysis demonstrated a relationship between low muscle strength and intensified depressive symptoms in older populations. Bearing in mind that depression is often unrecognized or underdiagnosed among older patients, lowered muscle strength should be an important sign for physicians and an incentive to screen them for depression.

IntroductionNo comprehensive needs assessment is performed routinely in Poland.PurposeThe goal of the study was to investigate the patterns of needs in older individuals living in long-term care institutions (LTCIs) using the Camberwell Assessment of Need for the Elderly (CANE) questionnaire, based on a previously published study protocol.Participants and methodsThe study included 306 LTCI residents (age: ≥75 years) with the a Mini-Mental State Examination (MMSE) score of at least 10 points. The dependence in basic activities of daily living was measured using the Barthel index (BI). A screening for depression was performed using the Geriatric Depression Scale (GDS) in subjects with an MMSE score of ≥15 points. Thereafter, CANE was used to analyze needs receiving adequate support (met needs) and those without appropriate interventions (unmet needs).ResultsThe mean age of studied individuals was 83.2±6.0 years. They had 10.4±3.2 met needs and 0.8±1.2 unmet needs. Unmet needs were reported most commonly in the following areas: company (15.9%), psychological distress (14.0%), intimate relationship (11.4%), eyesight/hearing/communication (11.4%), and daytime activities (11.0%). The OR of having a large number of met needs (ie, above the median) was almost eight times higher in residents with a BI score of 0–49 points versus those with ≥80 points. The group between (with 50–79 points) had this parameter almost four times higher. The OR of having a large number of unmet needs depended neither on BI nor on GDS and was more than four times higher in the group of 10–19 MMSE points (ie, with symptoms of moderate dementia) versus subjects with 24–30 MMSE points (ie, without symptoms of dementia).ConclusionWe defined the target group with high probability of unmet needs and the areas in which resources and efforts should be concentrated. We believe that the results can be used to optimize care in LTCIs.

[Purpose] The risk of falls in the elderly is an important public health problem. Suitable tests may help detect those at risk of falling. This study determined which balance test for older adults generates the most reliable results in terms of fall risk assessment, based on the number of falls over the last 12 months. [Subjects and Methods] A total of 153 individuals (31 males, 122 females, aged 76.67 ± 8.3 years; median 76.5, range 65–94) were investigated. The subjects were subdivided between fallers (a fall over the last 12 months) and non-fallers (no falls over the last 12 months). All participants were assessed with the following: Barthel Scale, Mini-Mental State Examination, Timed Up and Go, Tinetti Performance-Oriented Mobility Assessment), Berg Balance Test, and One-Legged Stance Test. [Results] Statistically significant differences were detected between fallers and non-fallers in TUG, POMA, BBS, and OLST scores. The number of falls correlated positively with the results for TUG, POMA, and OLST. [Conclusion] TUG and POMA were the most useful screening tests for balance and gait impairment in elderly nursing home residents. Two or more tests should be performed for more precise assessment of the risk of falling.