Contact dermatitis in the elderly: Some epidemiological aspects

Medicine, improvements in health care services and social progress have extended life expectancy which is predicted to grow in the future. To help improve the life quality of the elderly, the frequency and aetiological factors of contact dermatitis (CD) in subjects over and under 65 were investigated. From 1994 to 1996, 10,408 patients (7,069 female and 3,339 male) suffering from CD were patch tested with the GIRDCA standard series; 1,022 of these (9.8%) were over 65. Among the elderly, CD was more frequent in females (61.1%), but the percentage difference between men and women was significantly lower. One or more positive patch test reactions, scored according to the GIRDCA criteria, were present in 667 cases (65.3%). The allergens involved were similar to those in subjects under 65, but sensitivity to nickel sulfate and thimerosal was strongly decreased while that to balsam of Peru, wool alcohols and neomycin sulfate was increased. Also in the elderly, non-occupational CD (76.8%) was more common than occupational CD. The first was mainly caused by cosmetics and topical medicaments, the latter by housework and masonry. The intrinsic (i.e. immunosenescence, vasculature, vascular response) and extrinsic (i.e. exposure to environmental allergens, life habits, occupations) factors which may condition the rather low CD frequency among the elderly are discussed. Further investigations will have to adjust the GIRDCA standard series to the needs of the elderly population.