Contact Dermatitis in the Elderly: Predisposing Factors, Diagnosis, and Management

Increased aging of the general population is a well-known fact with serious effects on health systems worldwide. Skin aging involves various immunological and structural changes that increase the risk of numerous skin diseases such as contact dermatitis. Contact dermatitis is characterized by an inflammation of the skin caused by an interaction between the skin and external agents and is divided into irritant and allergic contact dermatitis. Irritant contact dermatitis occurs on skin areas directly exposed to irritant substances, which results in a stream of pro-inflammatory cytokines mediating the skin injury. Asteatotic and perineal irritant contact dermatitis are the most important subtypes of irritant contact dermatitis in the elderly. Allergic contact dermatitis is a T cell-mediated inflammatory reaction and requires a prior sensitization. The most common allergens responsible for allergic contact dermatitis in the elderly are fragrance mix, nickel, and balsam of Peru. Elderly patients with stasis dermatitis, chronic wounds, and chronic venous insufficiency have an increased prevalence of sensitization due to the frequent exposure to topical treatments. In this review, the most common types of contact dermatitis in the elderly are enumerated in order to assist dermatologists and other physicians to identify contact dermatitis in this distinct group of the population.