Jose Leonardo Barrera-Ariza

Skin manifestations frequently represent visible indicators of systemic disease and may provide important diagnostic clues during clinical evaluation. The objective of this review was to analyze the diagnostic value of dermatological manifestations associated with systemic disorders within the fields of internal medicine and endocrinology. A narrative review methodology based on the scientific method was utilized through the analysis of peer-reviewed literature indexed in PubMed, Scopus, ScienceDirect, and related biomedical databases. The review included studies focused on endocrine, metabolic, autoimmune, renal, hepatic, infectious, vascular, inflammatory, and neoplastic diseases associated with cutaneous findings. The analyzed evidence demonstrated that endocrine-metabolic disorders represented the most frequent group associated with dermatological manifestations, particularly diabetes mellitus, obesity, metabolic syndrome, thyroid dysfunction, and hyperandrogenic states. Common findings included acanthosis nigricans, xerosis, pigmentation changes, inflammatory rashes, vascular lesions, ulcers, and paraneoplastic dermatoses. Autoimmune diseases such as systemic lupus erythematosus and dermatomyositis also exhibited characteristic cutaneous patterns strongly associated with systemic inflammatory activity. Renal and hepatic diseases frequently presented with xerosis, chronic pruritus, jaundice, and vascular skin lesions, while paraneoplastic dermatoses demonstrated considerable relevance as potential indicators of occult malignancy. The review additionally highlighted the educational and interdisciplinary importance of dermatological examination in medical practice. Recognition of skin findings may improve diagnostic suspicion, facilitate earlier intervention, strengthen interdisciplinary collaboration, and support comprehensive patient-centered care. The findings reinforce the concept that the skin functions as a clinically meaningful reflection of systemic disease and should be considered an essential component of physical examination within internal medicine and endocrinology.

Geriatric psychodermatology has emerged as a relevant interdisciplinary field that explores the complex interaction between dermatological diseases and psychological processes in older adults. This review aims to analyze current evidence regarding therapeutic, educational, and research gaps in the management of psychodermatological conditions in elderly populations, with particular consideration of diverse healthcare contexts, including Latin American settings. A narrative review was conducted based on recent literature (2020 onward), integrating findings from high-impact studies indexed in major biomedical databases. The results demonstrate that chronic dermatological conditions such as pruritus, psoriasis, and atopic dermatitis are strongly associated with psychological burden, including depression, anxiety, sleep disturbances, and social isolation. The brain–skin axis provides a neuroimmunological framework explaining these interactions. Despite advances in understanding, significant gaps persist, particularly the predominance of symptom-focused treatment, lack of psychological screening, limited interdisciplinary care, insufficient training in psychodermatology, and scarcity of geriatric-specific research. These findings support the need for an integrative, patient-centered approach that incorporates biological, psychological, and social dimensions of care. Strengthening interdisciplinary collaboration, improving medical education, and promoting context-sensitive research are essential steps toward optimizing outcomes in elderly patients with psychodermatological conditions.