A simple self-diagnosis tool to assess the prevalence of dermatoporosis in France.
OBJECTIVE
The term dermatoporosis has been proposed to describe clinical signs and functional consequences of age-related extreme skin fragility.


OBJECTIVE
To create a simple dermatoporosis self-diagnosis tool (IDA: Index Dermatoporosis Assessment) and to use this tool to estimate the prevalence of dermatoporosis in France.


METHODS
A specific dermatoporosis questionnaire was developed with the help of senior dermatologists and survey experts. This questionnaire was submitted to consecutive individuals aged ≥65 years who consulted a dermatologist. At the end of the consultation, the dermatologist was asked to assess 'whether or not' dermatoporosis was present. In a second step, the final questionnaire was mailed to a representative sample of the French population aged ≥65 years in order to estimate the prevalence of dermatoporosis.


RESULTS
The initial questionnaire, consisting of two modules (24 questions), was validated in 173 individuals aged ≥65 years) during a dermatologist consultation. Dermatologists diagnosed 46% of the individuals with dermatoporosis. The final validated questionnaire consisted of 14 items, 12 consisting in presence or absence of clinical signs and two items consisting of the self-assessment by individuals of skin ageing on neckline and hands (none/moderate/significant/very significant). A scoring system was generated to quote quantitatively dermatoporosis (from 0 if no sign of dermatoporosis to 20 maximal dermatoporosis). The area under the receiver operator curve was 0.8535, indicating a very good ability of the questionnaire to differentiate between individuals. A cut-off value of 11 was linked to positive and negative predictive values of 0.78 and 0.81, respectively. In a second step, using the questionnaire in a representative sample of the French population (n = 533), the estimated overall prevalence of dermatoporosis was 37.5% in French subjects aged ≥65 years [27.5% (males) vs. 43.9% (females); P < 0.05]. The estimated prevalence of dermatoporosis was twice higher in subjects with eczema or atopic dermatitis during childhood than in the population without dermatoporosis (60.6% vs. 33.4%, P < 0.001). Individuals with dermatoporosis also reported a higher prevalence of itching, long-term corticosteroid use, anticoagulant use and prior sun exposure.


CONCLUSIONS
Using a new simple dermatoporosis self-diagnosis tool, this study provides a previously unprecedented insight into the high prevalence of dermatoporosis in elderly individuals. IDA questionnaire is a short (14-item) and easy to use tool for evaluating dermatoporosis in adults and may allow an easy evaluation of each subject.
University of Geneva, Geneva, Switzerland.
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Saurat
Département Exploration Cutanée, Centre de Recherche sur la Peau, Pierre Fabre Dermo-Cosmetique, Toulouse, France.
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Mengeaud
Medical Department, Laboratoires Dermatologiques Avène, Lavaur, France.
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Georgescu
Medical Department, Laboratoires Dermatologiques Avène, Lavaur, France.
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Coutanceau
Department of Dermatology, Hôpital Henri Mondor EA EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques) EA 7379, UPEC-Université Paris-Est Créteil, Créteil, France.
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Ezzedine
Public Health, European Market Maintenance Assessment-EMMA, Vincennes, France.|Public Health, Hôpital Necker-Enfants Malades, Maladies Rares en Dermatologie, Paris, France.
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Taïeb
D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D057566:Self Report; D015595:Skin Aging / Q000473:pathology*; D012871:Skin Diseases / Q000175:diagnosis* / Q000453:epidemiology*