C C Long1, R Marks. 1. Department of Dermatology, University of Wales College of Medicine, Heath Park, Cardiff.
Abstract
BACKGROUND: Generalized pruritus in the elderly is a common and distressing problem; often there is no evidence of skin disease other than xerosis. OBJECTIVE: The aim of the study was to determine whether any abnormality could be detected in the structure and function of the skin of patients with generalized pruritus. METHODS: The skin of 13 elderly patients with generalized pruritus, without skin disease or any underlying cause, was contrasted with that of age- and sex-matched normal control subjects. RESULTS: The patients had clinically drier skin (mean visual analogue scale score 2.9 [standard deviation +/- 2.2], controls 0.52 [+/- 0.59], p = 0.002). The severity of the pruritus was related to the degree of xerosis (r = 0.66). The patients had decreased skin surface conductance (10.7 mumho [+/- 3.4], controls 16 mumho [+/- 5.3], p = 0.017), and increased intracorneal cohesion (240.5 g [+/- 88], controls 162.7 g [+/- 39.8], p = 0.001). The patients also had statistically significantly diminished parameters of skin surface contour. CONCLUSION: The findings of increased intracorneal cohesion and altered skin surface contour parameters suggest that elderly patients with generalized pruritus may have an acquired abnormality of keratinization.
BACKGROUND: Generalized pruritus in the elderly is a common and distressing problem; often there is no evidence of skin disease other than xerosis. OBJECTIVE: The aim of the study was to determine whether any abnormality could be detected in the structure and function of the skin of patients with generalized pruritus. METHODS: The skin of 13 elderly patients with generalized pruritus, without skin disease or any underlying cause, was contrasted with that of age- and sex-matched normal control subjects. RESULTS: The patients had clinically drier skin (mean visual analogue scale score 2.9 [standard deviation +/- 2.2], controls 0.52 [+/- 0.59], p = 0.002). The severity of the pruritus was related to the degree of xerosis (r = 0.66). The patients had decreased skin surface conductance (10.7 mumho [+/- 3.4], controls 16 mumho [+/- 5.3], p = 0.017), and increased intracorneal cohesion (240.5 g [+/- 88], controls 162.7 g [+/- 39.8], p = 0.001). The patients also had statistically significantly diminished parameters of skin surface contour. CONCLUSION: The findings of increased intracorneal cohesion and altered skin surface contour parameters suggest that elderly patients with generalized pruritus may have an acquired abnormality of keratinization.