Skin Aging: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; furthermore:
    • Inspection (viewing).
      • Skin
        • Wrinkles
        • Sagging
        • Yellowish discoloration
        • Irregular pigmentation
        • Dryness
        • Roughness
        • Loss of elasticity
        • Age spots
        • Age warts
        • Angiomas (hematomas)
      • Hairiness
        • The color of the hair on the head is often yellowish dirty gray
        • Increased hair growth in the middle parts of the eyebrows (sideways eyebrow hair fall out), ears, nasal entrance.
      • Nails
        • Thick nails
        • Brittle nails
        • V. a. the nail of the big toe often changes its direction of growth and becomes misshapen thick
    • Inspection and palpation (palpation) of the thyroid gland [due todifferential diagnoses: hypothyroidism (hypothyroidism)].
  • Dermatological examination [due todifferential diagnoses:
    • Atopic eczema (neurodermatitis).
    • Bullous pemphigoid (synonyms: parapemphigus, senile pemphigus, erythema bullosum chronicum, dermatitis herpetiformis senilis) – chronic, blistering disease with bulging, subepidermal blisters that form on reddened or normal skin; the disease occurs in the elderly and occasionally in children.
    • Eczema (dermatitis (inflammation of the skin), especially with pruritus (itching) and erythema (areal redness of the skin)).
    • Elastosis (degeneration of the elastic fibers of the skin, which occurs with age).
    • Ichthyoses (genetic disease that leads to cornification disorders of the skin).
    • Keratosis senilis (horn and wart-like brown growths (skin patches) that occur mainly in the elderly after chronic exposure to light, with possible transition in squamous cell carcinoma).
    • Nevus cell nevi (birthmark)
    • Psoriasis vulgaris (psoriasis)
    • Pruritus senilis (itching of aging skin).
    • Purpura senilis (spontaneous skin bleeding due to vulnerable skin).
    • Seborrheic keratosis (age wart)
    • Senile angiomas (tumor-like vascular neoplasm).
    • Senile lentigines (brown sharply demarcated spots that appear with age (age spots)).
    • Xeroderma (dry, brittle skin) (hypersensitivity of the skin and mucous membrane to environmental influences)]

    [due topossible secondary diseases:

    • Eczematous manifestations (asteatotic eczema, exsiccation eczema, eczema craquelé) – especially on the extremities and often with excruciating itching (pruritus senilis).
    • Impaired wound healing due todecreasing immunocompetence (“immunosenescence).
    • Skin inflammation with thin vulnerable skin
    • Skin irritations
    • Purpura senilis (areal hemorrhages, especially on the upper extremities (aging skin is more sensitive to friction and shear trauma)).
    • Xereosis cutis (dryness of the skin).
    • Increase in inflammatory dermatoses such as bullous pemphigoid (characterized by bulging subepidermal blisters usually localized on an erythematous base)]
  • Cancer screening [due topossible sequelae: Increase in benign skin tumors such as seborrheic keratoses (Verrucae seborrhoicae), solar lentigines (Lentigines seniles; age spots) or senile angiomas; Increase in malignant skin tumors such as basaliomas, actinic keratoses as well as squamous cell carcinomas. Furthermore, the lentigo maligna, this is a pre-invasive melanoma]
  • Health check respectively anti-aging check.

Square brackets [ ] indicate possible pathological (pathological) physical findings.