A simple self‐diagnosis tool to assess the prevalence of dermatoporosis in France. (2nd May 2017) - Saurat, J.‐H.
Abstract: Importance: 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. Design, setting and participants: 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 and relevance: 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.