Leus Alet J G, Meijer Joost M, Zuidema Sytse U, Jonkman Marcel F
Universitair Medisch Centrum Groningen, afd. Dermatologie.
Universitair Medisch Centrum Groningen, afd. Huisartsgeneeskunde en Ouderengeneeskunde.
Ned Tijdschr Geneeskd. 2018 Dec 20;163:D2350.
Pruritus is the most common dermatological complaint in elderly people and may have a significant negative influence on quality of life. In elderly, the identification of the underlying cause of pruritus can be difficult, due to the broad differential diagnosis and the frequent occurence of comorbidities and polypharmacy. In daily practice, a classification can be used of 'pruritus with primary skin lesions' and 'pruritus without primary skin lesions' for a more specific search to the underlying cause. The most common cause of pruritus in elderly is dry skin (xerosis). In primary care pruritis is more often caused by a dermatosis and systemic causes are more rare. Besides treatment directed at the underlying cause, it is recommended in elderly to always treat xerosis with topical emollients. Topical therapy consists of corticosteroids, anaesthetics and anti-inflammatory agents. Systemic treatments include antihistamines, antidepressants and neuroactive medications.
瘙痒是老年人最常见的皮肤问题，可能对生活质量产生重大负面影响。对于老年人而言，由于鉴别诊断范围广泛，且合并症和多种药物治疗频繁出现，因此确定瘙痒的根本原因可能很困难。在日常实践中，可以使用“伴有原发性皮肤损害的瘙痒”和“无原发性皮肤损害的瘙痒”分类，以便更具体地查找根本原因。老年人瘙痒最常见的原因是皮肤干燥（干皮病）。在初级保健中，瘙痒更常由皮肤病引起，而全身性原因则较为罕见。除了针对根本原因进行治疗外，建议老年人始终使用外用润肤剂治疗皮肤干燥。局部治疗包括使用皮质类固醇、麻醉剂和抗炎药。全身治疗包括抗组胺药、抗抑郁药和神经活性药物。
