<Original Article> Systemic Disease as a Risk Factor for Dermatologic Abnormality in Elderly Nursing Home Patients

Although the prevalence and distribution of skin disease is well studied among nursing home patients, the contribution of systemic disease on dermatologic abnormality has not been clearly elucidated. We conducted a 4-year epidemiological investigation of skin disease among palliative care residents in Japan, Australia and Taiwan. The initial research phase involved a questionnaire survey of demographic variables followed by clinical skin examinations performed by specialist physicians.A total of 869 nursing home patients were recruited, with 381 coming from Taiwan (43.8% of the total), 352 from Australia (40.5%) and 136 (15.7%) from Japan. Stroke was the most common systemic disease (31.3%), followed by hypertension (25.4%), dementia (24.1%), heart disease (20.7%) and diabetes mellitus (16.8%). Xerosis was the most common skin disease (37.5%), followed by tinea unguium (34.2%), tinea pedis (15.8%), dermatitis (7.0%), tinea manum (5.4%) and scabies (1.4%). Stroke victims were 1.6 times more likely to suffer from skin disease than those who were not (OR 1.6, 95%CI 1.1-2.4, P = 0.0248). Similarly, patients suffering from dementia were 2.2 times more likely to have dermatologic abnormality (OR 2.2, 95%CI 1.4-3.3, P = 0.0003). Overall, this study has shown that stroke and dementia appear to be important systemic conditions influencing the development skin disease among nursing home patients.