Berger Timothy G, Steinhoff Martin
Department of Dermatology, University of California San Francisco, San Francisco, CA 94143, USA.
Semin Cutan Med Surg. 2011 Jun;30(2):113-7. doi: 10.1016/j.sder.2011.04.002.
Geriatric patients are frequently afflicted by pruritic dermatoses. Most pruritic elderly patients present with a skin eruption. The high prevalence of pruritic inflammatory skin disorders in elderly patients is a consequence of three physiological changes that occur with aging: (1) the epidermal barrier repair is diminished; (2) the immune systems of elderly patients are activated and have defective Th1 function along with enhanced Th2 function (immunosenescense); and (3) neurodegenerative disorders may lead to pruritus by their central or peripheral effects. These consequences of aging may all afflict the same patient, explaining why elderly people often have multiple overlapping skin conditions. The following article outlines the pathogenesis of the most common forms of pruritic skin disease in elderly patients and the hallmarks that allow the dermatologist to establish an accurate diagnosis and also suggests a management strategy for each common type of pruritic skin disease in the elderly patient.
老年患者常受瘙痒性皮肤病困扰。大多数瘙痒的老年患者会出现皮疹。老年患者瘙痒性炎症性皮肤病的高发病率是衰老过程中发生的三种生理变化的结果：（1）表皮屏障修复能力下降；（2）老年患者的免疫系统被激活，Th1功能缺陷，Th2功能增强（免疫衰老）；（3）神经退行性疾病可能通过其对中枢或外周的影响导致瘙痒。这些衰老的后果可能都影响同一患者，这就解释了为什么老年人常常有多种重叠的皮肤状况。以下文章概述了老年患者最常见的瘙痒性皮肤病的发病机制以及皮肤科医生用以准确诊断的特征，并针对老年患者每种常见类型的瘙痒性皮肤病提出了管理策略。
