Comprehensive Skin Health in Older Adults: A Case Study on Managing Skin Lesions

By Dr. David Wang, Village Dermatology

Skin health is essential as we age, especially with the increased likelihood of developing benign or concerning skin lesions. In this article, we discuss the case of a 71-year-old female patient who came in for a full-body skin exam to address new skin lesions on her lower leg and monitor existing growths. This case highlights the value of regular skin exams and provides insights into different types of common skin lesions, their characteristics, and recommended management practices.

Case Overview: Full-Body Skin Exam and Lesion Evaluation

Our patient presented with brown, moderate-intensity lesions on her left leg, which had been present for several months. After a detailed, head-to-toe examination, including dermatoscope use, we identified various lesions. Each lesion was carefully evaluated, allowing us to categorize them and create a personalized management plan.

Diagnoses and Treatment Recommendations

Below is a summary of the lesions identified, along with guidance on their management:

1. Benign Nevi

• Description: Symmetrical and evenly pigmented moles found throughout the skin.

• Management: These pigmented nevi are benign, and no intervention is required unless there are changes in size, shape, or color.

• Patient Advice: We recommended monthly self-skin exams and annual professional evaluations to monitor for any changes. For more on nevi, refer to our Mole Removal and Management page.

2. Cherry Angiomas

• Description: Small, bright red vascular growths that commonly appear with age.

• Management: Cherry angiomas are benign, but they can be removed with laser treatment or electrodesiccation for cosmetic reasons.

• Patient Advice: Since they are harmless, treatment is optional unless they are bothersome. Learn more about vascular lesions like cherry angiomas on our Skin Lesions page.

3. Lentigines

• Description: Light brown or tan spots, also known as "sun spots," that often appear on sun-exposed areas.

• Management: Lentigines can be managed with sunscreen, retinoids, chemical peels, or laser therapy to reduce their appearance.

• Patient Advice: We advised daily application of broad-spectrum sunscreen with SPF 30+ to protect against sun exposure, as UV rays can worsen lentigines.

4. Dermatofibroma

• Description: Firm, dome-shaped pink-tan nodules, usually on the lower legs, that dimple when pinched.

• Management: Dermatofibromas are benign and only require removal if they are symptomatic or increase in size.

• Patient Advice: Since these lesions are stable, removal is generally not necessary unless the patient experiences discomfort.

5. Seborrheic Keratosis

• Description: Warty, stuck-on lesions with a greasy or waxy texture.

• Management: These benign growths are common with age and do not require treatment unless desired for cosmetic reasons.

• Patient Advice: We assured the patient that seborrheic keratoses are harmless. For more about their management, refer to our Seborrheic Keratosis page.

6. Neoplasm of Uncertain Behavior

• Description: A darkly pigmented papule on the suprapubic area with an uncertain diagnosis.

• Management: Neoplasms like this may be observed, biopsied, or surgically removed depending on clinical suspicion.

• Patient Advice: We advised monitoring and instructed her to report any changes, including non-healing, bleeding, or ulcerating lesions. If needed, we can conduct a biopsy to further evaluate. Learn more on our Skin Cancer Screening page.

Sun Protection and Skin Monitoring Recommendations

To reduce the risk of further skin damage and new lesions, we recommended:

• Daily use of SPF 30+ broad-spectrum sunscreen

• Monthly self-skin exams to detect changes early

• Annual professional skin exams to monitor any new or evolving lesions

Our patient received comprehensive education on self-care and monitoring for changes in her skin. For those seeking more guidance, our Skin Cancer Prevention page provides detailed information on protective measures and the importance of routine check-ups.

Conclusion

Regular skin examinations are essential for detecting and managing both benign and potentially concerning lesions, especially as we age. At Village Dermatology, we are committed to educating patients on skin health and providing personalized care plans. Whether you're managing benign growths or monitoring suspicious lesions, our team is here to support your journey to optimal skin health.

For more information or to schedule your annual skin exam, visit Village Dermatology.