Xerosis and pruritus in the elderly-recognition and management

Abstract

The pathophysiology of xerosis is related to abnormal keratin production; elderly have decreased skin fatty acids that result in decreased skin barrier and hydration. The perceived itch of pruritus induces scratching and subsequently immunologically mediated inflammation. The condition is often associated with several underlying dermatological and systemic diseases. However, pruritus can be psychogenic in origin. Xerosis is the most common underlying dermatological condition. Several infectious, metabolic, hepatic, hematological and other systemic conditions are associated with pruritus. Immediate relief of pruritus is the initial treatment goal. After initial pruritic relief, a thorough history, physical examination and laboratory testing work-up is necessary to find the underlying treatable cause including genetic predisposition. Once the underlying etiology is uncovered, an effective pruritic treatment strategy is tailored to etiology. © Springer-Verlag London Limited 2008.