title: Dermatologic surgery in geriatric patients: psychosocial considerations and perioperative decision-making.
abstract: BACKGROUND
  Dermatologic surgery, both for cutaneous malignancies and for management of the visible signs of photodamage, is frequently performed on older persons.
  
  
  OBJECTIVE
  To review common psychologic and physiologic limitations among the elderly that may affect their ability to tolerate cutaneous surgery and to outline a stepwise approach for management of these conditions during the perioperative period.
  
  
  METHODS
  Literature review, MEDLINE (1966-2001) search, and personal experience.
  
  
  RESULTS
  Communication with patients, their families, and their physicians, management of patients' underlying medical problems, and special sensitivity to patients' cognitive and physiologic limitations can minimize perioperative risk during cutaneous surgery in the elderly.
  
  
  CONCLUSIONS
  Given appropriate physician management, elderly patients can usually safely undergo cutaneous surgery.
authors.affiliation: Division of Cutaneous and Aesthetic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
authors.forename: Murad
authors.initials: M
authors.lastname: Alam
authors.forename: Robert A
authors.initials: RA
authors.lastname: Norman
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Goldberg
mesh_terms: D000368:Aged; D003142:Communication; D003657:Decision Making; D062109:Dermatologic Surgical Procedures; D015577:Geriatric Assessment; D006801:Humans; D010817:Physician-Patient Relations; D011182:Postoperative Care; D012307:Risk Factors; D012944:Social Support