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Background:According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients.Methods:We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case.Results:Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus.Conclusion:Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance.

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The complex endocrinologic, immunologic, metabolic, and vascular changes associated with pregnancy may influence the skin in various ways. Pregnancy-specific dermatoses represent a heterogeneous group of pruritic skin diseases that have been reclassified recently as pemphigoid gestationis, pruritic urticarial papules and plaques of pregnancy (PUPPP), intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy [1]. Mechanisms leading to pregnancy-specific dermatoses may be a reflection of the hormonal and immunological changes associated with pregnancy that may potentially pose a serious risk to the fetus [2]. Diagnosis and timely treatment of these dermatoses are necessary as these can pose a risk to the fetus, such as prematurity and low birth weight.In our study, we observed the frequency distribution and progression of specific dermatoses of pregnancy (Table 1) in 250 randomly selected pregnant women attending the antenatal clinic of our hospital over a period of 1 year. There are two units of the gynecology and obstetrics department at our hospital; we selected all new patients attending the antenatal clinic of one of the units on one particular day in a week, which was their outpatient department day and our free day. In total, 54.4% of patients in our study were primigravida, whereas 45.6% were multigravida.Among the specific dermatoses, PUPPP has been described in the literature as the most common gestational dermatosis. In our study, the frequency was 1.2% and all the three women affected with PUPPP were multigravida, with the onset of lesions in the third trimester. Roger et al. [3] reported the frequency to be one in 120-240 pregnancies. Of the pregnant women with PUPPP, 85.7% were primagravida in the study carried out by Kumari et al. [4]. In a study carried out by Rudolph et al.[5], 70% of pregnant women were primigravida and 30% were multigravida. The average gestational age at the onset of eruption was reported to be 35 weeks by Holmes et al. [6], which is comparable to our findings. The abdomen (especially the striae) was the most common site and papules were the most common type of lesions. The exact etiology is not known, but it has been proposed that stretching of the skin damages the connective tissue, causing subsequent conversion of nonantigenic molecules into antigenic molecules, leading to skin eruption. They reported that larger babies and increased maternal weight gain most likely lead to an increased abdominal girth. Maternal and fetal prognoses remain excellent [7]. In our study, two patients were administered topical steroids and antihistaminics; however, in one patient systemic steroids had to be administered because of intractable itching. All the mothers delivered normal healthy babies without any skin rash and the maternal lesions resolved spontaneously within 6 days after delivery.Intrahepatic cholestasis of pregnancy (ICP) was observed in two (0.8%) patients of our study. Roger et al. [3] reported an incidence of 0.5%. Patients had moderate pruritus and secondarily de...