Pruritus in the elderly: management by senior dermatologists.

Abstract

Pruritus in older patients is common, yet remains a challenge for clinicians. By virtue of their years of experience and older age, senior dermatologists may have developed opinions and approaches that are insightful. A random sample of board-certified dermatologists older than 64 years of age was surveyed by a written anonymous questionnaire to assess their opinions, diagnostic approaches, and treatments of pruritus and xerosis in the older adult. The 63 respondents whose surveys were analyzed believe the most common cause of generalized pruritus in the elderly is xerosis. Of those respondents who believe laboratory evaluation is necessary for generalized pruritus in this population, a complete blood cell count and a multichemistry panel were the most frequently ordered tests. Treatment regimens and products recommended were highly variable and included topical emollients, corticosteroids, and others. The most common systemic agent employed was hydroxyzine hydrochloride, followed by corticosteroids, doxepin, diphenhydramine, and terfenadine. Various topical, physical, and miscellaneous treatments were recommended. This study provides a glimpse into the diagnostic and therapeutic approaches of senior dermatologists.