Skin aging and dermatoporosis-the chronic skin fragility syndrome

Skin aging is divided into intrinsic and extrinsic aging, encompassing pigmentary, vascular, connective tissue, and fat tissue aspects that contribute to this complex process. Aging is genetically determined but is influenced by environmental factors such as ultraviolet radiation, air pollution, and smoking. Skin aging has not only cosmetic but also functional implications, as the loss of the extracellular matrix, especially hyaluronate, impairs the mechanical functions of the skin. Hyaluronate, which stabilizes skin structures, acts as a cushion and reduces susceptibility to skin tears. Dermatoporosis, a term coined by Saurat, describes the functional dimension of skin aging, manifesting in various stages from skin atrophy to severe complications like skin necrosis. It is increasingly observed in older patients, particularly from age 70 onwards. Prevalence ranges from 22% in women to 38% in men, with higher rates in patients undergoing chronic steroid therapy and certain conditions. Diagnosis is made through clinical examination and skin thickness measurement via ultrasound. Prevention involves limiting exposure to harmful factors and using specific treatments such as hyaluronic acid and topical retinoids to improve skin health.