PRURITUS IN THE ELDERLY. PATHOPHYSIOLOGICAL, CLINICAL, LABORATORY AND THERAPEUTIC APPROACH

Authors

  • Tatiana TARANU University of Medicine and Pharmacy ″Grigore T. Popa″ - Iaşi
  • St. TOADER University of Medicine and Pharmacy ″Grigore T. Popa″ - Iaşi
  • Irina ESANU University of Medicine and Pharmacy ″Grigore T. Popa″ - Iaşi
  • Mihaela Paula TOADER University of Medicine and Pharmacy ″Grigore T. Popa″ - Iaşi

Keywords:

PRURITUS, PATHOPHYSIOLOGY, ELDERLY, SYSTEMIC DISEASE, TREATMENT

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.

Author Biographies

  • Tatiana TARANU, University of Medicine and Pharmacy ″Grigore T. Popa″ - Iaşi

    Faculty of Dental Medicine
    Discipline of Oral Dermatology

  • St. TOADER, University of Medicine and Pharmacy ″Grigore T. Popa″ - Iaşi

    Faculty of Dental Medicine
    Discipline of General and Oro-maxillo-facial Pathology

  • Irina ESANU, University of Medicine and Pharmacy ″Grigore T. Popa″ - Iaşi

    Faculty of Dental Medicine
    Discipline of Internal Medicine

  • Mihaela Paula TOADER, University of Medicine and Pharmacy ″Grigore T. Popa″ - Iaşi

    Faculty of Dental Medicine
    Discipline of Oral Dermatology

References

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Additional Files

Published

2018-05-14

Issue

Section

INTERNAL MEDICINE - PEDIATRICS