Prevalence, predictors and comorbidity of dry skin in the general population

Augustin, Matthias; Kirsten, Natalia; Körber, Andreas; Wilsmann‐Theis, Dagmar; Itschert, G.; Staubach‐Renz, Petra; Maul, Julia‐Tatjana; Zander, Nicole E.

doi:10.1111/jdv.15157

Cited by 83 publications

(108 citation statements)

References 16 publications

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“…The term ‘comorbidity’ was used as published previously to characterize any association of two or more disease entities regardless of causality. For this, distinct skin diseases occurring in a single individual are commonly named ‘comorbid dermatological conditions’ . Although there may be pathogenetic associations between a number of inflammatory skin conditions, such as psoriasis and seborrhoeic dermatitis, we kept these conditions as separate entities and used the term ‘comorbidity’.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population‐based study in 161 269 employees

et al. 2019

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Summary Background Seborrhoeic dermatitis is a common but epidemiologically poorly researched chronic skin disease. Objectives To characterize the prevalence and dermatological comorbidity of seborrhoeic dermatitis in Germany. Methods In the course of voluntary company skin checks, full‐body examinations were carried out in more than 500 companies by experienced dermatologists and documented electronically. Results In total, 161 269 participants were included (men 55·5%, mean age 43·2 ± 10·9 years). Seborrhoeic dermatitis was identified in 3·2% (men 4·6%, women 1·4%). A significant difference was found between age groups (2·0% in < 35; 3·6% in 35–64; 4·4% ≥ 65 years). The most frequent concomitant skin conditions were: folliculitis [17·0%, 95% confidence interval (CI) 15·9–18·1], onychomycosis (9·1%, 95% CI 8·3–10·0), tinea pedis (7·1%, 95% CI 6·3–7·8), rosacea (4·1%, 95% CI 3·6–4·7), acne (4·0%, 95% CI 3·4–4·5) and psoriasis (2·7%, 95% CI 2·3–3·2). Regression analysis revealed the following relative dermatological comorbidities when controlling for age and sex: folliculitis [odds ratio (OR) 2·1, 95% CI 2·0–2·3], contact dermatitis (OR 1·8, 95% CI 1·1–2·8), intertriginous dermatitis (OR 1·8, 95% CI 1·4–2·2), rosacea (OR 1·6, 95% CI 1·4–1·8), acne (OR 1·4, 95% CI 1·2–1·7), pyoderma (OR 1·4, 95% CI 1·1–1·8), tinea corporis (OR 1·4, 95% CI 1·0–2·0), pityriasis versicolor (OR 1·3, 95% CI 1·0–1·7) and psoriasis (OR 1·2, 95% CI 1·0–1·5). Conclusions Seborrhoeic dermatitis is a common disease, which is more prevalent in men and older people, and it has an increased rate of dermatological comorbidity. However, absolute differences in the prevalence of comorbidities are small and negligible. Nevertheless, the findings underline the need for integrated, complete dermatological diagnostics and therapy.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population‐based study in 161 269 employees

et al. 2019

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“…Occupational screening exams in Germany (n = 48,380) have revealed that approximately every third employee (29.4 %) between the age of 16 and 70 years is affected by xerosis cutis. There is no gender predilection . The prevalence increases with increasing age (55.6 % at a mean age of 75.1 years) .…”

Section: Background and Rationalementioning

confidence: 94%

“…Augustin et al. (2018) have shown that xerosis cutis is associated with an increased risk of developing axillary dermatitis, atopic dermatitis, exsiccation eczematoid, psoriasis, plantar warts and seborrheic dermatitis . Elderly, care‐dependent individuals with dry skin show a diminished defense against external pathogens and an increased risk of developing decubital ulcers .…”

Section: Background and Rationalementioning

confidence: 99%

Diagnosis and treatment of xerosis cutis – a position paper

Augustin

Wilsmann‐Theis²,

Körber³

et al. 2019

J Deutsche Derma Gesell

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Summary Background and rationale Xerosis cutis (also referred to as xeroderma, dry skin, asteatosis) affects more than 10 million individuals in Germany. It is among the most common dermatological diagnoses and a cardinal symptom of many dermatological, internal and neurological diseases. Even though it has been established that basic skin care plays a significant role in the management of patients with xerosis cutis, there are as yet no evidence‐based algorithms for diagnosis and treatment. Objective The present position paper provides physicians across all specialties with a practical, symptom‐based approach to the prevention, diagnosis and treatment of xerosis cutis. Methods Within a structured decision‐making process, a panel of experienced dermatologists first defined questions relevant to everyday clinical practice, which were then addressed by a systematic review of the literature. Based on the evidence available as well as expert consensus, diagnostic and treatment algorithms were subsequently developed and agreed upon. Results Xerosis cutis is generally diagnosed on clinical grounds. Possible trigger factors must be avoided, and comorbidities should be adequately and specifically treated. Suitable skin care products should be chosen with a view to improving skin hydration and restoring its barrier function. They should therefore contain both rehydrating and lipid‐replenishing components. The “drier” the skin appears, the greater the lipid content should be (preferably using water‐in‐oil formulations). The choice of ingredients is based on a patient's individual symptoms, such as scaling (e.g., urea), fissures/rhagades (e.g., urea or dexpanthenol), erythema (e.g., licochalcone A) and pruritus (e.g., polidocanol). Other factors to be considered include the site affected and patient age. Ingredients or rather combinations thereof for which there is good clinical evidence should be preferentially used. The best evidence by far is available for urea, whose efficacy in the treatment of xerosis is further enhanced by combining it with other natural moisturizing components and ceramides. The “xerosimeter” is a tool developed in an effort to facilitate patient management and for training purposes. It not only includes practical tools for diagnosis and follow‐up but also a classification of ingredients and a structured treatment algorithm. Conclusion The structured symptom‐ and evidence‐based approach proposed herein contains a road map for diagnosis and treatment of xerosis cutis. It aims to raise awareness in terms of prevention and early treatment of this condition and may thus improve quality of life and prevent potential sequelae.

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“…The effects caused by the vehicle seem to be more pronounced than the result obtained with a urea-ceramide-lactate-based formulation, which was previously proposed for the treatment of dry skin [32]. Since a stable epidermal barrier function is related to optimal skin hydration, especially elderly persons could benefit from topicals containing Lactococcus lysate, as they are particularly prone to suffering from xerosis [33-35]. …”

Section: Discussionmentioning

confidence: 85%

Reconstructed Human Epidermis Predicts Barrier-Improving Effects of <b><i>Lactococcus lactis</i></b> Emulsion in Humans

Hausmann

Hertz-Kleptow

Zoschke

et al. 2019

Skin Pharmacol Physiol

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Background/Aims: The skin provides protection against chemical, physical, and biological stressors, yet the skin morphology changes over the course of life. These changes might affect the skin barrier function and facilitate the onset of age-related diseases. Since orally applied lactic acid bacteria ameliorate signs of aged and atopic skin, we investigated the effects of a topically applied Lactococcus lactis emulsion. Methods: In a blinded, randomized, vehicle-controlled trial, we studied topical Lactococcus effects both in vitro and in 20 healthy female volunteers. Commercially available reconstructed human epidermis (RHE) was treated for 4 days (once daily) and volar forearms were treated for 30 days (twice daily). Results: Lactococcus formulations improve the skin barrier in RHE as shown by increased filaggrin and human β-defensin-2 expression as well as by the 23% declined mean apparent permeability coefficients for caffeine. A reduction of 18% in transepidermal water loss confirms this effect in humans. Moreover, Lactococcus emulsion optimized skin hydration and surface pH. Skin irritation was not detected. Conclusions: Lactococcus emulsion improved the skin barrier function with good biocompatibility. Moreover, our study exemplifies the translational predictive capacity of testing on RHE with respect to Lactococcus emulsion.

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Prevalence, predictors and comorbidity of dry skin in the general population

Abstract: Dry skin is a frequent condition in the adult general population and needs special attention. Known risk factors may facilitate identifying patients at risk for deterioration.

Cited by 83 publications

References 16 publications

Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population‐based study in 161 269 employees

Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population‐based study in 161 269 employees

Diagnosis and treatment of xerosis cutis – a position paper

Reconstructed Human Epidermis Predicts Barrier-Improving Effects of <b><i>Lactococcus lactis</i></b> Emulsion in Humans

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