Atopic Dermatitis in the Elderly Population

Abstract

Atopic dermatitis is a common inflammatory disease with a chronic and relapsing course. Although considered a childhood disease, it is now evident that atopic dermatitis is also common in adulthood and in the elderly population. Atopic dermatitis typically manifests with bilateral and symmetrical eczematous lesions on the face, trunk and skin folds. Itch is invariably present and may be very severe, markedly affecting daily life and sleep. In older adults, atopic dermatitis may have a high level of impact on quality of life, frequently burdening an already complex comorbid situation. The full assessment of disease burden (localizations, itch severity, sleep alterations, impact on quality of life, disease history, comorbidities) is crucial to identify the most appropriate treatment. In many cases, moderate-to-severe atopic dermatitis in the elderly population can be successfully and safely treated with biological agents inhibiting the interleukin-4/-13 pathway, whereas the use of Janus kinase inhibitors may pose concerns about the safety profile.

Fig. 1

Atopic dermatitis of the face in older women (age range 82–94 years). Lesions are symmetrical and more severe in the periorbital region. Written permission to publish the photos was obtained from the patients.

Fig. 2

Atopic dermatitis affecting the face, volar surface of upper arms and legs in older patients (age range 78–87 years). Lesions are typically symmetrically distributed. Written permission to publish the photos was obtained from the patients.