Sunday, January 15, 2006

pruritus (itching of the skin)

Pruritus is a skin disorder with a variety of causes, including allergy, parasitic infestations, diabetes mellitus, liver disorders, and emotional distress. One type of pruritus that occurs in older individuals is caused by a degeneration of the skin. Pruritus without lesions is generally due to an internal problem such as diabetes mellitus, liver disorder, psychiatric disturbance, or the use of certain drugs such as tetracycline or alcohol. The most common type in an older individual is pruritus with lesions, and this is caused by the skin's inability to retain water. If pruritus occurs in the genital areas it may be caused by infection or infestation, but if these are ruled out, the abrasiveness of the dye in toilet tissue should be considered. Other causes may include allergy to detergents or soaps and the use of synthetic underwear. Cotton underwear absorbs perspiration and allows air to circulate better. Symptoms of pruritus include dry scaly skin, itching, skin lesions, and a slight decrease
of the sensation of the skin.
Treatment of pruritus should first involve determining the cause. With successful treatment of underlying systemic problems, pruritus often will disappear. Pruritus caused by drugs will usually disappear when the drugs are discontinued.
Pruritus caused by degeneration of the skin may be treated with many things. Increasing the humidity in the home environment is useful. Using a humidifier or vaporizer in homes with central heat or air is helpful. Bathing less frequently in water that is not extremely hot is usually recommended. Oil-based soaps such as Dove or Caress and bath oils or mineral oil in the bath water should be used. It is important to remember when using bath oils there is a risk of injury from slipping in the tub. Topical applications of lotions or oils have a great therapeutic value. Sometimes antihistamines and systemic steroids will control symptoms more rapidly.
Pruritus caused by skin degeneration in the older person is not curable but is treatable. When any of the above treatments are used all symptoms may disappear, but if treatment is discontinued they may reappear.
Brocklehurst, J. C. Textbook of Geriatric Medicine and Gerontology. New York: Churchill Livingstone, 1985.

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