Pruritus in older people

Abstract

Pruritus in older people is caused by a wide range of dermatological, systemic, neurological and psychogenic diseases. It can also be attributed to various cutaneous drug reactions. The dermatological, neurological and immunological changes associated with ageing predispose older people to pruritus of a wide range of aetiologies. The most common cause of pruritus in older people is xerosis, or dry skin. Regular use of emollients is the mainstay of treatment for pruritus of any cause, with general measures aiming to ensure optimal skin hydration and to prevent the itch-scratch cycle. Topical treatments are generally better tolerated for localized pruritus. Anti-histamines are the predominant agents to treat pruritus, but can be inadequate in many cases. Numerous other systemic agents have been demonstrated to alleviate pruritus depending on the cause, but may be limited by their adverse effects. This article reviews the current published literature on pruritus in older people, with a practical approach to its evaluation and management in non-specialist settings.

A Psychometric Evaluation of the Chinese Version of the 5D Itch Scale in Taiwanese Elderly

“…It is a complex phenomenon and usually defined as an unpleasant itching sensation which evokes a strong desire to scratch the affected skin at least three times within 2 weeks, lasting more than 5 minutes per episode and persisting for more than 6 weeks (Metz, Grundmann, & Stander, 2011;Zucker, Yosipovitch, David, Gafter, & Boner, 2003). It is also considered a human defense mechanism that may signal underlying diseases or malignancies (Chen & Yesudian, 2013). The prevalence rate of pruritus increases with age, ranging from 40% to 66% (Chen & Yesudian, 2013;Cowdell, 2009;Patel &Yosipovitch, 2010).…”

“…It is also considered a human defense mechanism that may signal underlying diseases or malignancies (Chen & Yesudian, 2013). The prevalence rate of pruritus increases with age, ranging from 40% to 66% (Chen & Yesudian, 2013;Cowdell, 2009;Patel &Yosipovitch, 2010). Shive and colleagues (2013) found that 26% of seven million people who searched for medical care due to pruritus were older adults.…”

Delusional infestation: a prototype of psychodermatological disease

“…Refer to Table for a list of prescribed medications and medical conditions which are known to cause pruritus and paresthesias without the delusion of an infestation. A patient's medication list and medical history should be carefully reviewed prior to proceeding to the next step of the diagnosis Once it is determined that a patient has both a delusion of an infestation plus the tactile symptoms, the patient likely has DI.…”

Delusional Infestation and Chronic Pruritus: A Review

“…Lynn S. KIMSEY (2,13,18,27,29) X X X Alcoholism (29,30) X X Anemia (13,27,31) X X Autoimmune disease (12, 33) X X Carbon monoxide poisoning (29,35) X X Cancer a (2,13,18,34,36) X X X Cholestasis (2,13,18,27,34,36,37) X X X Cirrhosis (2,34,37) X X Diabetes mellitus (2,13,27,29,34,36) X X X Drug abuse (2,29,36) X Fluoride poisoning (34,38) X X Heavy metal toxicity (29,39) X X Hemochromatosis (34) X Hepatic disease (12, 34) X X Hepatitis B, C (13,27,36) X X X Hyperthyroidism (2,13,27,34,36,…”

“…These patients suffered from brain cysticercosis, cerebrovascular disease, pernicious anemia, and peripheral neuropathy. Finally, two studies found that more than half of the population over the age of 70 suffers from itch without obvious cause (18,27).…”