The Ageing Skin

Question 1

How does the Epidermis change?

How does the Dermis change?

Answer 1

- Atrophy and Dry
o ↓Sebum production
o ↓Vit D production
o ↓Langerhans cells
o ↓Melanocytes - Paler skin, Reduced tolerance to sun exposure
o Slower repair

- Atrophy
o Sagging and wrinkling due to loss of Collagen
o ↓Sweat gland activity
o ↓Hair follicles - Thin, sparse hair
o ↓Blood supply - Harder to lose heat

Question 2

Thermoregulation:
What changes cause it to be affected?
→ What does this increase the risk of?

What does the decline in thermoregulation increase the risk of?

Pain receptor:
What changes occur? What does this lead to?
→ What does this increase the risk of?

Answer 2

• Dermal thinning, Reduced moisture retention, and Reduced ability to vasodilate in capillary bed (Prone to heat retention)
  → Dehydration
• Hypo/Hyperthermia

• Dermal thinning = ↓Nerve endings = ↓Sensation
  → Pressure ulcers

Question 3

Where does a Pressure injury normally occur?

When does a Pressure injury occur? Why?

What is a Moisture lesion? Why does it occur?

Where does a Moisture lesion normally occur?

What do both of these injuries/lesions indicate?

Answer 3

• Over bony prominences e.g. Sacrum, Heels
• When an area is compressed, causing ischaemia and tissue death
• Redness or partial thickness skin loss as both the epidermis and dermis have excessive moisture from either urine, faeces or sweat
• Can occur anywhere in the body
• Immobility, Poor nutrition, and Poor care

Question 4

OTHER SKIN CONDITIONS:
Xerosis - What is it? What’s it due to?

Itchy skin - What’s it associated with?

Vasculitis - What does it present with?
→ What are the 2 types of it?

Cellulitis - What is it? What does it present with?

Lipodermatosclerosis - What is it? What’s it due to? What does it present with?

Answer 4

• Dry skin, due to reduced moisture and loss of oil glands
• Dryness, rashes and other medical issues e.g. psoriasis
• Raised palpable purple areas/spots
  → • Reactive vasculitis - secondary to acute infection
  • Vasculitis secondary to an underlying inflammatory process
• Infection of skin with rapid onset of unilateral, progressive redness (bright pink)
• Inflammation of lower legs due to venous insufficiency, presenting with deep red colour and is bilateral

Question 5

Causes of Swollen Legs:
Fluid Overload - What’s it commonly due to?

Oedema - How does it differ to fluid overload?
→ What does is reduce with?

Low protein - What does it present with?

Iatrogenic - How does it cause swollen legs?

Lymphoedema - How does it present early and late?
→ What are the 2 types of it?

Answer 5

• Heart failure
• Similar, but not due to heart failure
  → Leg elevation
• Oedema in all extremities
• Drugs affect lymphatic drainage = fluid retention
• In early stages, it’s pitting and similar to fluid overload, but in later stages, the skin hardens and tightens
  → • Primary - problem in the development of lymphatic system
  • Secondary - due to damage to lymphatic system e.g. surgery