Common Benign Melanocytic and Non-Melanocytic Skin Tumors among the Elderly: Results of the Graz Study on Health and Aging

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Abstract

Background and Objectives

Benign skin tumors are the most common skin findings and contribute to the major reasons for consulting a dermatologist. However, the frequency of benign skin tumors concerning different body areas and their relationship with sun-related behavior have not been sufficiently characterized. We aimed to improve knowledge about the anatomic distribution of the most frequently occurring benign skin tumors among a healthy predominant elderly population. Furthermore, we investigated associations with sun-related habits.

Methods

In total, 100 participants, 37 men, and 63 women (mean age: 67.2 years; range: 46–86 years) were enrolled in the Graz Study on Health and Aging (GSHA) cohort. Full body images were investigated for melanocytic nevi, seborrheic keratoses, hemangiomas, dermatofibromas, and lentigines. Information on the phenotypic trait, sun exposure, use of sun-protective measures, and history of sunburns was collected in a questionnaire.

Results

Common melanocytic nevi were the most frequently encountered skin lesions. Male sex was associated with multiple common nevi on the abdomen and the presence of atypical nevi. High sun exposure in central European latitudes during adolescence was positively associated with multiple common nevi on the total body. Multiple common nevi and atypical nevi on the back correlated with frequent use of sunscreens with SPF during young adulthood and adolescence, respectively.

Conclusion

Our study adds new knowledge about the most frequently occurring benign skin tumors, considering all visible body areas. This research may serve as a reference basis for following epidemiological studies.

Related collections

Most cited references 38

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The prevalence of skin diseases in the elderly: analysis of 4099 geriatric patients.

Emine Tamer, Nuran Alli, Mutlu Hayran … (2006)

The geriatric population is composed of persons over 65 years of age, and few studies are available on the dermatologic diseases in this group. Data on a total of 4099 geriatric patients admitted between the years 1999-2003 were analyzed. Hospital-based patient registry records were used for data collection. The data were analyzed according to age, sex, and time of admittance. The five most frequently encountered diseases in elderly patients were eczematous dermatitis, fungal infections, pruritus, and bacterial and viral infections. The most common disorders in males were fungal, bacterial, and viral infections, disorders of the feet, cutaneous ulcers, and vesiculo-bullous diseases, whereas, in females, they were immune-rheumatologic diseases and disorders of the mucous membranes. The five most frequently encountered diseases were significantly different in geriatric age subgroups. In the younger age group, pruritus, disorders due to sun exposure, and precancerous lesions and skin carcinomas were less common, whereas eczematous dermatitis was more common. The frequencies of some diseases showed significant seasonal variations. Infestations were more common in spring and summer, fungal infections were more common in summer but less so in winter, pruritus was more common in autumn but less so in spring, disorders due to sun exposure were more common in spring, and benign neoplasia were more common in autumn. In 2003, benign neoplasia, precancerous lesions and skin carcinomas, and immune-rheumatic disorders were more common, but vesicular and bullous diseases, fungal infections, and cutaneous lymphomas were less common when compared with the year 1999. This study provides important data on the frequency of dermatologic diseases in elderly patients, and shows variations in the frequency depending on age, gender, and season. We believe that this study will create awareness about the extent and patterns of dermatologic problems in geriatric patients.

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Sunscreen use and increased duration of intentional sun exposure: still a burning issue.

Philippe Autier, Mathieu Boniol, Jean-François Doré (2007)

Sunscreen use is often proposed for sun protection because of their ability to block UV-induced sunburns (the sun protection factor--SPF). Among suntan seekers, however, risk of cutaneous melanoma may be increased because of extended sun exposure duration. We made a systematic review of the evidence linking sunscreen use to sun exposure duration. Five observational studies found that when sun exposure was associated with willingness to get a tan or to stay longer in the sun (i.e., intentional sun exposure), sunscreen use was associated with duration of sun exposure 13-39% longer. Paradoxically, sunburns tend to be more frequent among sunscreen users, probably because of greater natural sun sensitivity. When sun exposure was not intentional, sunscreen use did not increase time spent in the sun. Two European double-blind randomized trials conducted among young sun seekers found daily sun exposure duration, especially sunbathing, 19-25% longer with use of SPF 30 than with use of SPF 10 sunscreens. One randomized trial in a holiday resort in France found a 3-13% increase in sun exposure duration with use of SPF 12 versus SPF 40 sunscreen. But, the SPF 12 groups used 3.6-4.2 more sunscreen than the SPF 40 group, and thus the actual SPF in the SPF 12 group was higher than in the SPF 40 groups. In conclusion, sunscreen use leads to longer duration of sun exposure when sun exposure is intentional, but not when sun exposure is non intentional.

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Pigmentary changes of the ageing skin.

J P Ortonne (1990)

In subjects older than 25-30 years the number of enzymatically active melanocytes detectable by the dopa reaction decreases by about 10-20% per decade, with exposed skin having approximately twice as many pigment cells as unexposed skin. Chronic exposure to sunlight may stimulate the epidermal melanocyte system rather than accelerating chronological ageing. The number of melanocytic naevi declines with age. Despite the decreased melanocyte density, photoaged skin has irregular pigmentation and, frequently, there is hyperpigmentation. This may be due to greater positivity of dopa of chronically irradiated melanocytes. Heterogeneity in skin colour in exposed areas of skin is due to uneven distribution of pigment cells, a local loss of melanocytes, and a modification in the interactions between melanocytes and keratinocytes. The most common pigmented lesions in sun-exposed skin include ephelides, actinic lentigo, pigmented solar keratoses and seborrhoeic keratoses, and lentigo maligna. The white spots in aged skin are usually stellate pseudoscars or idiopathic guttate hypomelanosis. Greying of the hair is due to progressive loss of melanocytes from the hair follicles. In vivo and in vitro studies are necessary to increase overall understanding of the processes involved and to improve treatment of the pigmentary changes in ageing skin.

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Author and article information

Journal

Journal ID (nlm-ta): Dermatology

Journal ID (iso-abbrev): Dermatology

Journal ID (publisher-id): DRM

Title: Dermatology (Basel, Switzerland)

Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )

ISSN (Print): 1018-8665

ISSN (Electronic): 1421-9832

Publication date (Print): June 2023

Publication date (Electronic): 19 January 2023

Publication date PMC-release: 19 January 2023

Volume: 239

Issue: 3

Pages: 379-386

Affiliations

[1] ^aDepartment of Dermatology and Venereology, Medical University of Graz, Graz, Austria

[2] ^bResearch Unit for Genetic Epidemiology, Molecular Biology and Biochemistry, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria

[3] ^cDepartment of Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria

[4] ^dDepartment of Ophthalmology, Medical University of Graz, Graz, Austria

Author notes

*Viktoria Gruber, viktoria.gruber@ 123456medunigraz.at

Article

Publisher ID: drm-0239-0379

DOI: 10.1159/000529219

PMC ID: 10273912

PubMed ID: 36657431

SO-VID: ed61aed2-01f8-4ac4-bc29-46290b55e3ac

License:

This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

History

Date received : 19 May 2022

Date accepted : 8 January 2023

Date: 2023

Page count

Tables: 4, References: 41, Pages: 8

Funding

This study was supported in part by the City of Graz and the Austrian Ministry of Science under the aegis of the EU Joint Programme − Neurodegenerative Disease Research − www.jpnd.eu.

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