Management of pruritus in the elderly Praktischer Umgang mit Pruritus im Alter

Witte F.; Zeidler C.; Ständer S.

Abstract

Background: Chronic pruritus (CP), a frequent (20.3%) symptom in the elderly, increases with age. It has a significant impact on the quality of life, ranking among the 50 most burdensome diseases worldwide (Global Burden of Disease Study). Objectives: The aim is to provide an overview of the symptom CP in the elderly and to improve differentiation of underlying conditions and management of this entity. Materials and methods: A literature search in PubMed was performed, using the terms ‘pruritus’, ‘elderly’ and ‘gerontodermatology’. Results: The main causes of CP in the elderly are the physiologic aging process (xerosis cutis, immunosenescence, neuropathy), the increase in potentially pruritic diseases with increasing age (diabetes mellitus, chronic renal failure), and polypharmacy. Therapeutic options relate to causes, severity of pruritus, and individual patient factors (multimorbidity, impaired organ function). The recently updated S2k guideline ‘Diagnosis and therapy of chronic pruritus’ is helpful. Conclusion: CP in the elderly is challenging for both patients and physicians. Not only the difficulty of identifying the underlying cause, but the complexity of treatment and its tolerability and practicability determines these patients’ further burden.