JOURNAL READING

INTRODUCTION

Occurs in Disrupst skin

winter or low barrier
humidity function

Common
dermatological Increases the
symptoms in risk of pruritus
older people Dry
Skin
 INTRODUCTION
Dry skin
Prevalence : 29.5%-58.3% in older patients in
nursing homes/primary care facilities
Two majors reason :
Characteristics of participants
Method to define dry skin
Most studies were conducted in out-patient setting
or nursing home
 INTRODUCTION
Methods to evaluate the presence or severity of dry
skin :
Self-administered questionnaire-based method
using the visual analogue scale
Observation-based method for visually apparent
symptoms by experts
Subjective evaluation in older peoples overlook
the presence of dry skin
 INTRODUCTION

Objective method : electrical method

measure the capacitance / conductance
in skin surface using a device

No studies have compared these

different methods to asses dry skin for
community-dwelling older people
 INTRODUCTION
caused by chronological aging (reduce SC
Dry Skin lipids and NMF) and external factors

Previous focused on non-modifiable factors

(age,sex,season,a history of atopic dermatitis
Studies and dry skin, and genetic factors)

Other evaluate the short-term effect of moisturizers

or cleansing in an experiment design
Studies
 INTRODUCTION
Few Studies
Evaluated lifestyle-related
behavior and dry skin, but
they include young and
older people
This Study
Investigate skin hydration
status of the lower legs by
comparing several methods
Examining lifestyle-related
factors of skin care in
community-dwelling older
people
 Study Design
A cross-sectional, observational study in Japan from
2013-2014
Performed at community center, public apartments
in a suburban city, and temporal housing region in a
northeast rural area
Conducted in September to February
Corresponding to autumn to winter
 Participant
People who voluntarily attended the health checkup
program at each setting (n=157)

Inclusion criteria Exlusion criteria

Age > 65 years Age <65 years

Their activities of daily Unknown demographics
living were independent Decline to participate
Could walk to the Incomplete skin
program with minimal examination
assistance
 Data Collection

Skin hydration status evaluated by SC hydration by

capacitance method
Appearance of dry skin evaluated by Specified
symptom sum (SRRC) score
Subjective perception of dry skin evaluated using
the Visual Analogue Scale (0-100mm)
Data Collection
Self-administered questionnaire include questions
regarding : age, sex, comorbidities, dermatological
disease, medications, and lifestyle factors
Lifestyle factors : frequency of moisturizer use,
moisturizing form, bathing habits, types of soaps
and outdoor activities that assessed sun exposure
 Statistical Analysis
Associations among skin hydration measurement
Spearmans correlation coefficient / kappa index for
categorical variables
Differences in SC hydration between group t-test
Statistical significance p <0.050
Analyses were conducted STATA version 13
 Result
Association between objective & subjective skin
hydration :
SC hydration was significantly correlated with SRRC
score, but not with the visual analogue scale (VAS)
Age didnt affect kappa indices for severe dry skin,
moisturizer use didnt influence agreement level
Those who perceived dry skin during exercise
significantly lower SC hydration than those who
didnt
Those who always perceived dry skin /perceived dry
skin during sleeping lower SC hydration than those
who didnt
Factor associated with SC hydration
 Discussion
Low agreement between objective & subjective
evaluation of dry skin
Lifestyle-related factor: bathing,skin care, systemic
conditions associated with SC hydration
educational intervention may modify these factors
The measurement of SC hydration by a portable
device correlated with an observation method by
a health professional, but wasnt correlated with the
VAS score
 Discussion
Subjective evaluation overlook the presence of
dry skin for older people
Systemic illness related to dermatological
diseases
SC hydration was higher in males than females
Diuretics arent expected to be a positive factor for
SC hydration
 Discussion
There are several limitations to this study
This study showed factors of dry skin on the lower
legs that were protected by the sun and were likely
affected by blood flow
 Conclusion
SC hydration measurement adequate association
with observation-based evaluation by experts,but low
agreement with subjective evaluation of dry skin
Use of the electrical method for SC hydration
possible in an epidemiological survey for community-
dwelling older people
Hospitalization experience&lifestyle factor related to
skin care / bathing habits associated with skin
hydration
POPULATION
INTERVENTION
COMPARISON
OUTCOME
VALIDITY
 Recruitment
Question : as a defined, representative sample of
patients assembled at a common(usually early)
point in the course of their disease?
This review : Yes

This review : Yes

 Adjustment
Question : Was there adjustment for important
prognostic factors?

This review : NO
 Maintenance
Question : Was patient follow-up long enough for
the clinical outcome?
This review : Yes
 Measurement
Question : Was the assessment of outcomes either
objective or blinded to exposure?
This review : Yes, the assessment was objective
 Measurement
Question : Was the assessment of outcomes either
objective or blinded to exposure?
This review : Yes, the assessment was blinded
Outcome
 IMPORTANCY
Question : How precise are the estimates?
This review :
 APPLICABILITY

Do your patient have similar characteristic with the

patient in the research? YES
Can the result be applied to my patient care ? NO
CONCLUSION

Research reported in the

journal is VALID

IMPORTANCY of the
research reflected in the
journal

The Result reported in the

journal is NOT
APPLICABLE