Diagnostic challenges in the mature patient: Growing old gracefully

Skin diseases in the elderly are frequent and sometimes misleading, due to age-related changes that alter the clinical presentation. Clinicopathologic correlation is often the clue for distinguishing among various pathologies for which clinical signs are more striking than the histopathologic findings. Pitfalls are always lying in wait to ambush inexperienced dermatologists, but usually the microscope provides subtle hints to solve the quandary. In an attempt to familiarize physicians with emerging skin care demands of older patients, we have reviewed major diagnostic challenges in this group of patients: age-related changes, more common skin pathologies in mature patients, manifestations of comorbidity, skin tumors, and paraneoplastic syndromes.