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Pruritus of senescence
Other Resources UpToDate PubMed

Pruritus of senescence

Contributors: Jeffrey M. Cohen MD, Susan Burgin MD
Other Resources UpToDate PubMed


Pruritus (itch) is an extremely common dermatologic complaint, especially among older individuals. Pruritus may occur as a consequence of another condition or may be a primary condition. It may be localized to one region of the body or generalized, and the location, character, and timing of symptoms vary based on the presence of an underlying cause. This summary focuses on generalized pruritus in the elderly population.

The most common cause of pruritus in the elderly is xerosis (dry skin), in which the findings are often subtle. The skin fails to retain water as it ages, and sebaceous and sweat gland activity decrease. These factors are exacerbated during the winter months when cool air and central heating cause increased evaporation of moisture. Generalized pruritus in the elderly may also be related to numerous other age-related findings such as alteration of neural pathways, increased mast cell degranulation, or increased skin sensitivity to histamine. Many medications, including narcotics, imidazoles, and B vitamins (niacin), may cause pruritus (see pruritus without rash).

Pruritus can have an enormous impact on quality of life, leading to social embarrassment, sleeplessness, and a variety of secondary skin conditions. It is important to try to determine the cause of itch and provide appropriate therapy.


L29.8 – Other pruritus

42570001 – Senile pruritus

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Differential Diagnosis & Pitfalls

When skin findings are present:
  • Scabies
  • Pediculosis corporis
  • Herpes zoster
  • Xerosis
  • Atopic dermatitis
  • Allergic contact dermatitis
  • Nummular dermatitis
  • Exanthematous drug eruption
  • Lichen planus
  • Urticaria
  • Immunosuppression-associated eosinophilic folliculitis
  • Bullous pemphigoid
  • Sunburn
  • Transient acantholytic dermatosis
  • Dermatitis herpetiformis
  • Mastocytosis in adults 
  • Miliaria rubra
  • Psoriasis
When skin findings are absent or secondary:
  • Neuropathic pruritus
  • Psychogenic pruritus
  • Polycythemia vera
  • Lymphoma
  • Uremia
  • Hypothyroidism- and Hyperthyroidism
  • Iron deficiency anemia
  • Multiple myeloma
  • HIV/AIDS-related pruritus
  • Medication-induced pruritus (see Pruritus without rash)
  • Cholestatic pruritus
  • Malignant carcinoid
  • Systemic parasitic infections
  • Diabetes mellitus (Diabetes mellitus type 1 or Diabetes mellitus type 2)
  • Multiple sclerosis
  • Bullous pemphigoid

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Last Reviewed:01/14/2021
Last Updated:01/17/2021
Copyright © 2024 VisualDx®. All rights reserved.
Pruritus of senescence
A medical illustration showing key findings of Pruritus of senescence : Dry skin, Pruritus
Clinical image of Pruritus of senescence - imageId=417077. Click to open in gallery.  caption: 'Cracked, scaly, erythematous papules and plaques (eczema) occuring secondary to xerosis.'
Cracked, scaly, erythematous papules and plaques (eczema) occuring secondary to xerosis.
Copyright © 2024 VisualDx®. All rights reserved.