Immune-mediated dermatologic skin disorders in the senior patient

The baby boomer population, marching on the journey from infancy through the portals of middle life, now enters an uncertain period of life in which the only certainty is the fact that all the biological clocks continue the countdown toward the inevitable failure of a previously well-served immune system. We are faced with the ever-increasing probability that the very immune system that sustained us so well throughout our youth will eventually falter, predisposing us to a vast array of disorders resulting in immune dysregulation. It is in this setting that I will review the dermatologic disorders that may befall the "senior" patient as we journey toward that stage of life where we, as physicians and as an aging population ourselves, encounter a whole new set of medical challenges as we make the turn at the bend in the road. Accordingly, this review will focus on autoimmune bullous disorders, cutaneous manifestations of systemic disease, endocrine disorders, skin cancers, and paraneoplastic syndromes.