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[老年人瘙痒症的管理]

[Management of pruritus in the elderly].

作者信息

Witte F, Zeidler C, Ständer S

机构信息

Klinik für Hautkrankheiten, Kompetenzzentrum chronischer Pruritus, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland.

出版信息

Dermatologie (Heidelb). 2023 Sep;74(9):670-677. doi: 10.1007/s00105-023-05207-5. Epub 2023 Aug 20.

Abstract

BACKGROUND

Chronic pruritus (CP), a frequent (20.3%) symptom in the elderly, increases with age. It has a significant impact on the quality of life, ranking among the 50 most burdensome diseases worldwide (Global Burden of Disease Study).

OBJECTIVES

The aim is to provide an overview of the symptom CP in the elderly and to improve differentiation of underlying conditions and management of this entity.

MATERIALS AND METHODS

A literature search in PubMed was performed, using the terms 'pruritus', 'elderly' and 'gerontodermatology'.

RESULTS

The main causes of CP in the elderly are the physiologic aging process (xerosis cutis, immunosenescence, neuropathy), the increase in potentially pruritic diseases with increasing age (diabetes mellitus, chronic renal failure), and polypharmacy. Therapeutic options relate to causes, severity of pruritus, and individual patient factors (multimorbidity, impaired organ function). The recently updated S2k guideline 'Diagnosis and therapy of chronic pruritus' is helpful.

CONCLUSION

CP in the elderly is challenging for both patients and physicians. Not only the difficulty of identifying the underlying cause, but the complexity of treatment and its tolerability and practicability determines these patients' further burden.

摘要

背景

慢性瘙痒(CP)是老年人常见(发生率为20.3%)的症状,且随年龄增长而增加。它对生活质量有重大影响,在全球50种负担最重的疾病中位列其中(全球疾病负担研究)。

目的

旨在概述老年人的CP症状,并改善对潜在病因的鉴别以及对该病症的管理。

材料与方法

在PubMed中进行文献检索,使用了“瘙痒”“老年人”和“老年皮肤病学”等术语。

结果

老年人CP的主要病因是生理衰老过程(皮肤干燥、免疫衰老、神经病变)、随着年龄增长潜在瘙痒性疾病的增加(糖尿病、慢性肾衰竭)以及多种药物治疗。治疗选择与病因、瘙痒严重程度以及个体患者因素(多种疾病并存、器官功能受损)有关。最近更新的S2k指南“慢性瘙痒的诊断和治疗”很有帮助。

结论

老年人的CP对患者和医生来说都是一项挑战。不仅确定潜在病因存在困难,而且治疗的复杂性及其耐受性和实用性决定了这些患者的进一步负担。

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