Prevalence of dermatopathies in the elderly in primary health care: a narrative review

• DOI: https://doi.org/10.22533/at.ed.1595725210114

• Palavras-chave: Primary care, elderly, dermatopathies.

• Keywords: Primary care, elderly, dermatopathies.

• Abstract:

  Primary Health Care (PHC) is the first level of health care and plays an essential role in health promotion and disease prevention, aiming to guarantee the principles of the Unified Health System (SUS) in Brazil. In the current context of population aging in Brazil and globally, dermatological complaints stand out as a frequent demand among elderly people assisted in PHC. Skin ageing, classified as intrinsic and extrinsic, results from physiological and environmental factors, which increases the prevalence of conditions such as xerosis, pressure ulcers and dermatitis. This study aims to analyze the prevalence of dermatopathies in the elderly in primary care, emphasizing the prevalence of conditions, the pathophysiology of senescence and the particularities of skin diseases in the context of health. The methodology adopted was a narrative review on the prevalence of dermatopathies in the elderly with a focus on Primary Health Care. The research used the PICO strategy, with descriptors related to the elderly (Aged, Older people), Primary Health Care (SUS), dermatopathies (Skin Disease) and prevalence (Prevalence, Incidence). The searches were carried out on the BVSalud, LILACS, PubMed/MedLine and Cochrane Library databases, resulting in 192 articles. The initial screening was conducted using the Rayyan application, which identified and excluded 154 duplicates, leaving 114 articles. After applying relevance criteria, 10 articles were selected. Complementary searches in databases such as DATA SUS and SciELO added a further 5 articles, bringing the total to 15. The articles were fully assessed by the researchers in order to extract data in line with the study's objectives. Epithelial ageing is a complex biological process that results in significant changes in the skin of the elderly, making it more susceptible to dermatological diseases. Several theories explain these phenomena, including cellular senescence, telomere shortening and mutations in mitochondrial DNA, which compromise cell regeneration and increase oxidative stress. With ageing, there is a decrease in the production of essential substances such as cholesterol and collagen, affecting the skin barrier, skin elasticity and cell repair capacity. These changes make the skin more vulnerable to injury and reduce its capacity for regeneration and immune defense. These physiological changes explain the higher incidence of dermatopathies among the elderly, such as xerosis (the prevalence of xerosis in the elderly varies between 29.5% and 58.3%), onychomycosis, solar melanosis and dermatitis, which are also influenced by comorbidities such as diabetes, venous insufficiency and hypertension. In addition, polypharmacy, common among the elderly, contributes to the appearance of drug eruptions. The lack of guidance on skin care in health services, especially in primary care, is also a precursor to the high prevalence of dermatological conditions. The article highlights the importance of early diagnosis and ongoing care to prevent and treat skin diseases, improving the quality of life of the elderly and minimizing the social and psychological impact of dermatopathies.