Skin pathology of the elderly patients : Case of black African

Skin pathologies of the elderly subjects are varied and display diagnosis, management, and follow-up issues [1]. Their symptomatology differs from that of the young subjects [2]. Several studies have been done in many countries to determine the profile of these disorders in the elderly [3-6]; however, the skin diseases of aged patients were undocumented in Côte d’Ivoire. The purpose of this study was to describe the features of cutaneous pathology in the elderly patients at the Department of Dermatology in Bouaké, Côte d’Ivoire.


DISCUSSION
In this study, the major reasons for consultation of the elderly were chronic pathological conditions.The small sample size of our population was the limitation of study.Therefore, we cannot extrapolate our results to all seniors in the city of Bouake and in the country.The issues of affordability of people in care could explain the small number of patients admitted at the hospital during the study period.
Interestingly, because of socio-economic, cultural, and health context and mildness of some skin diseases, people would undergo traditional treatments or selfmedication.Despite these limitations, this study has documented the main reasons of consultations of the elderly.In our study, the proportion of the elderly was lower than that reported in Tunisia [3,4] and in Taiwan [5].These results can be explained by the relative short life expectancy related to poverty and deficient health systems in Subsaharan Africa.In Ivory Coast, the rate of the elderly people was 3.9% of the population in 2014.Pitché et al. have identified significant difference between skin disorders in the elderly individuals and those in the general population.They revealed that mycosis, eczema, and pruritus were frequent in while eczema, mycosis, and the acne were the most occurring in the general population [7].
The high frequency of pruritus in the elderly is related to their age, their skin aging, and the xerosis.However, acne is a skin disease occurring in adolescents, and thus, representing the third reason of consultation in the youth who predominates in the general population.
Mycosis followed by eczema was the most common reason of consultation in the elderly in Tunisia as in our study [3,4] compared with the Western countries where eczema followed by tumors were the most prevalent (Table 2).The climatic factors such as heat and humidity could be explain the high rate of mycoses in Africa.
The low value of malignant tumors in our study is discordant with several studies [3][4][5][8][9][10].This  difference is due to genetically pigmented skin of our patients whose dense epidermal melanin protects them from ultraviolet radiation [11], and therefore, preventing them from skin cancers.In the present study, Kaposi sarcoma was the most common cancer which is similar to that of several Subsaharian African studies [12,13] and different from that of developed country studies in which basal cell carcinoma was the most prevalent [3][4][5].
This unusual frequency of the Kaposi sarcoma results from the increase of HIV prevalence in Africa [14].Among benign tumors, keloids were predominant in our study compared to other studies where cysts or seborrheic keratoses were frequent [3].

CONCLUSION
This study shows a small proportion of the elderly subjects 65 years and older at the Dermatology Department in Bouaké.Cutaneous mycoses are the most common skin diseases in these patients in Africa.
The most occurring mycoses could be due to the heat and the humidity.

Table 1 :
Dermatoses reported in our series

Table 2 :
Common dermatoses of the elderly in our series *BT: Benign tumor, **MT: Malignant tumor