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Pruritus of the elderly
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Pruritus of the elderly

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Contributors: Kathryn Bowers MD, Pat Condry MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Pruritus (itch) is an extremely common dermatologic complaint, especially in the aged population. It is both a symptom of disease as well as a distressing condition by itself, meriting special attention by the clinician. Depending on location and associated skin findings, pruritus may be thought of as localized or systemic, secondary to a primary skin disease, or not. For the purpose of this synopsis, generalized pruritus (especially with respect to the elderly population) will be considered.

The most common cause of pruritus in the elderly is xerosis (dry skin), in which the findings are often subtle. The skin fails to retain water as it ages, and sebaceous and sweat gland activity decrease. These factors are exacerbated during the winter months when cool air and central heating cause increased evaporation of moisture. Generalized pruritus in the elderly may also be related to numerous other age-related findings such as alteration of neural pathways, increased mast cell degranulation, or increased skin sensitivity to histamine. Narcotics, imidazoles, and B vitamins (niacin) are common medication-induced causes of pruritus (see pruritus without rash).

Pruritus can have an enormous impact on quality of life, leading to social embarrassment, sleeplessness, and a variety of skin conditions. Every effort should be made to determine the cause of itch and render the appropriate therapy.

Codes

ICD10CM:
L29.8 – Other pruritus

SNOMEDCT:
42570001 – Senile pruritus

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Skin findings present:
No or secondary skin findings only:

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Therapy

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References

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Last Updated: 09/28/2017
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Pruritus of the elderly
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Pruritus of the elderly : Dry skin, Pruritus
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