Prevalence of eczema among older persons: A population-based cross-sectional study

Abstract

Background: There are very few population-based studies on the prevalence of eczema among older persons Aims: To estimate the prevalence and types of eczema in those aged 65 years or more in the community and to evaluate the effectiveness of community-based interventions for case finding. Methods: In the first stage of this cross-sectional survey, trained health workers of a non-governmental organization surveyed the eligible population and identified persons likely to have eczema. In the second stage, dermatologists examined such persons to ascertain the diagnosis. Statistical analysis was done using Epi Info software version 7. Prevalence of eczema was expressed in percentages. Chi-square test was used for comparing the difference in prevalence of eczema in various age groups and sex. Results: Health workers identified 98 persons as possible cases of eczema after interviewing 385 older persons in the community. Among them 95 persons were examined by dermatologists and 44 were confirmed to have eczema (diagnostic accuracy of health workers = 46.3%).Point prevalence of eczema was 11.4% (44/385). Prevalence was similar in males and females. It was greater (18.2 %) among persons aged 81 years or more. Asteatotic eczema, gravitational eczema and lichen simplex chronicus were the more common types of eczema. Limitations: Possible underestimation of the prevalence rates due to limited medical knowledge of health workers; limited facilities for examination and investigations at the medical camps and home visits. Conclusion: There appears to be a considerable burden of eczema among older persons in the community. A community-based approach involving non-governmental organizations has the potential to identify cases and offer care close to their homes.

Skin health of community-living older people: a scoping review

“…The most often investigated skin condition was melanoma and/or non-melanoma skin cancer ( n = 34) [ 22 , 23 , 26 , 48 – 56 , 60 , 61 , 63 , 64 , 66 , 69 , 71 , 73 , 75 – 80 , 82 – 84 , 86 , 89 , 93 , 94 , 97 , 101 ], three studies did not specify ‘skin cancer’ [ 32 – 34 ]. Different types of ‘eczema’ (including atopic dermatitis) were included in eight studies [ 30 , 31 , 33 , 34 , 46 , 65 , 88 , 91 ], pressure injuries [ 45 , 68 , 81 , 85 , 90 , 99 ] and psoriasis [ 29 , 33 , 34 , 57 , 58 , 100 ] each in six studies, and xerosis/ichthyosis in five studies [ 24 , 25 , 27 , 45 , 47 , 95 ]. Other studies focused on vitiligo [ 33 , 34 , 47 , 62 ] and parasites [ 33 , 34 , 47 , 92 ], bullous pemphigoid [ 59 , 87 , 98 ], intertrigo [ 67 , 74 ...…”

“…Table S6 (Supplementary material 5) presents details of included studies regarding review question 2. Most studies ( n = 10) described self-reported skin concerns/complaints or symptoms such as pruritus [ 20 , 34 , 40 , 42 , 45 , 65 , 102 – 105 ]. Nine studies reported mortality [ 53 , 63 , 64 , 71 , 77 , 79 , 97 , 98 , 106 ] and seven studies dermatology-related medical visits [ 37 , 42 , 43 , 107 – 109 ] or hospital admissions [ 110 ].…”

Community Dermatology: Current Status and the Way Forward

“…[ 16 ] Task shifting can be at different levels – general practitioners (GPs),[ 17 18 ] pharmacists, nurses,[ 19 20 ] physician assistants,[ 21 ] and community health workers. [ 12 22 23 ] The value of non-physician health workers in the delivery of care for non-communicable diseases in low- and middle-income countries has been supported by systematic reviews. [ 24 ]…”

“…[ 60 ] Partnership with NGOs foster community-led healthcare initiatives. [ 12 61 ] Various agencies including government and private agencies – as individuals, neighborhood groups, and NGOs– working together in public–private partnerships can sustain public health interventions including community dermatology. The involvement of reputed educational institutions and influential opinion makers such as religious, social, and political leaders are important facilitating factors.…”

“…There have been several reports about the relevance of community dermatology, including from developing countries. [ 9 10 11 12 ] Community-based interventions could be useful in chronic non-communicable skin diseases such as vitiligo, eczema, and psoriasis. However, there are few randomized controlled trials from dermatology providing evidence for its effectiveness.…”