Weisshaar E, Mettang T
Abt. Klinische Sozialmedizin, Schwerpunkt: Berufs- und Umweltdermatologie, Ruprecht-Karls Universität Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland.
Fachbereich Nephrologie, DKD Helios Klinik, Wiesbaden, Deutschland.
Hautarzt. 2018 Aug;69(8):647-652. doi: 10.1007/s00105-018-4223-5.
Due to demographic change, especially in Western countries with increasing life expectancy and a continuously increasing number of elderly, chronic pruritus (CP) is more and more observed in clinical practice. CP in elderly may present with specific pruritic skin diseases, as chronic prurigo (nodular form) and can also occur in unaffected, normal looking skin. CP in elderly remains a challenge. Especially CP without any skin lesions is a major diagnostic and therapeutic challenge. Due to the increasing prevalence of malignant diseases in elderlies, paraneoplastic pruritus is also an important differential diagnosis. Treatment depends on the mobility of the patient which determines if and which topical agents can be used and if ultraviolet phototherapy can be administered. There are a number of topical and systemic medications, which must be selected according to existing comorbidities, possible drug interactions, and the patient's compliance as well as possible side effects such as cognition and sedation. All this may hamper treatment of CP in elderly.
由于人口结构变化，尤其是在预期寿命不断延长且老年人数量持续增加的西方国家，慢性瘙痒（CP）在临床实践中越来越常见。老年人的CP可能表现为特定的瘙痒性皮肤病，如慢性痒疹（结节型），也可能发生在外观正常、未受影响的皮肤。老年人的CP仍然是一个挑战。尤其是没有任何皮肤病变的CP是主要的诊断和治疗难题。由于老年人恶性疾病的患病率不断上升，副肿瘤性瘙痒也是重要的鉴别诊断。治疗取决于患者的活动能力，这决定了是否以及可以使用哪些外用药物，以及是否可以进行紫外线光疗。有多种外用和全身性药物，必须根据现有的合并症、可能的药物相互作用、患者的依从性以及可能的副作用（如认知和镇静作用）来选择。所有这些都可能妨碍老年人CP的治疗。
