Management of older patients with atopic dermatitis

Atopic dermatitis is a multifactorial genetic inflammatory skin disorder, which is characterized by pruritus, a chronic relapsing course, and age-specific location and morphology of lesions. Atopic dermatitis is detected in 2%–3% of older individuals. In Russia, the incidence of atopic dermatitis is approximately 80 cases per 100,000 population. Males are affected three times more than females. Approximately 30% of patients with atopic dermatitis aged 60 years and older report no history of this condition, whereas 20% report episodes of the disease in childhood. New-onset atopic dermatitis in patients aged 60 years and older is diagnostically challenging. Pruritus is the most prevalent skin-related complaint in older patients, even without a history of atopy. In the United States, this debilitating symptom affects one-quarter of patients with atopic dermatitis over 65 years receiving outpatient treatment. Furthermore, this complaint is typical of other skin diseases and conditions, such as diabetes mellitus, malignant neoplasms, renal failure, hepatic disorders, thyroid disorders, polycythemia vera, side effects of systemic drugs, scabies, and xeroderma. Atopic dermatitis is relatively uncommon in older individuals; however, its prevalence is increasing, and managing such patients is challenging. This review examines various therapeutic options in older patients, including drug therapy.