title: Pruritus in the elderly. Pathophysiological, clinical, laboratory and therapeutic approach.
abstract: Generalized pruritus is a common symptom in elderly, patients, with severe impact on the quality of life. The diagnosis of senile idiopathic pruritus is made after the exclusion of a systemic disease such as chronic renal disease, hepatobilliary disease with cholestasis, thyroid dysfunctions, drug-induced hypersensitivity reactions, visceral or hematological neoplasia, and primitive dermatological distinct conditions. The pathophysiological mechanisms are still unclear. A critical role is considered to be played by changes related to skin aging, cutaneous nerve supply and other nervous system components. The clinical approach requires a thorough assessment of general health status. In primary skin conditions, a biopsy and direct immunofluorescence (DIF) are required, while in pruritus associated with a systemic disorder, the assessment of hematological, biochemical and immunological parameters and imaging are necessary. The treatment of a patient with chronic pruritus is often palliative and individualized, with emollients, sedating and non-sedating antihistamines, tricyclic antidepressants, gabapentinum, and narrow-band UVB phototherapy. Pruritus associated with systemic disease may be alleviated by etiologic treatment.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Tăranu
authors.forename: St
authors.initials: S
authors.lastname: Toader
authors.forename: Irina
authors.initials: I
authors.lastname: Eşanu
authors.forename: Mihaela Paula
authors.initials: MP
authors.lastname: Toader
mesh_terms: D000368:Aged; D000375:Aging; D000588:Amines / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001706:Biopsy; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004643:Emollients / Q000627:therapeutic use; D019085:Fluorescent Antibody Technique, Direct; D000077206:Gabapentin; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D010789:Phototherapy; D011537:Pruritus / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012867:Skin / Q000294:innervation / Q000503:physiopathology*; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
chemical_list: D000588:Amines; D014151:Anti-Anxiety Agents; D000929:Antidepressive Agents, Tricyclic; D003509:Cyclohexanecarboxylic Acids; D004643:Emollients; D006633:Histamine Antagonists; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin