Willan's itch and other causes of pruritus in the elderly

Ward, Julian; Bernhard, Jeffrey D.

doi:10.1111/j.1365-4632.2004.02553.x

Cited by 77 publications

(67 citation statements)

References 60 publications

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“…The reported prevalence of SD in the geriatric population is 31 % [60]. Within the elderly population, SD has been associated with localized itch [61,62]. SD is a particularly common skin manifestation in elderly patients with Parkinson's disease, depression or anxiety [63,64].…”

Section: Cutaneous Conditionsmentioning

confidence: 99%

Chronic Pruritus in the Elderly: Pathophysiology, Diagnosis and Management

2015

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Chronic itch in the elderly is a common problem, with a significant impact on quality of life and sleep in elderly patients. Chronic itch may be attributable to several causes, including dry skin, immunosenescence and neural degeneration. Itch may also be caused by skin diseases, such as seborrhoeic dermatitis and stasis dermatitis; systemic conditions, such as end-stage renal disease and diabetes; and psychogenic conditions, such as depression and anxiety. The use of polypharmacy may also cause itch, with or without a rash. Specifically, thiazides and calcium channel blockers have been known to cause itch in elderly patients. Management should be tailored according to the underlying dermatological or systemic aetiology of itch. Topical treatment is the mainstay of therapy, providing special emphasis on skin hydration and barrier repair. In addition, topical and oral medications that target the nervous system and reduce neuronal hypersensitization, such as gabapentin and selective antidepressants, have a role in treating patients with severe chronic itch. Furthermore, management must account for changes in metabolism and pharmacokinetics of drugs in the aging population in order to prevent the occurrence of adverse effects.

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Section: Cutaneous Conditionsmentioning

confidence: 99%

Chronic Pruritus in the Elderly: Pathophysiology, Diagnosis and Management

2015

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“…The patient presented some of these incriminating elements, but we assumed that the determining factor was represented by chronic pruritus. After excluding local and systemic causes of itch (cholestasis, uremia, hyperthyroidism, medications or lymphoma), the dermatologist established the diagnostic of idiopathic pruritus of the elderly or so-called Willian's itch [13].…”

Section: Discussionmentioning

confidence: 99%

Subpectoral pacemaker implant after repeated pocket complications due to "senile pruritus"

Ursaru¹,

Ignat²,

Corduneanu³

et al. 2017

Arch Clin Cases

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Complications that can occur after pacemaker implant may be surgical or programming function related. We report a case of an 89-years old patient with slow atrial fibrillation, initially treated by external temporary pacing, and then by permanent pacemaker implant. The clinical course in the first months after procedure was uneventful, but after a half-year from the first admission, the patient addressed for pacemaker pocket infection, complaining of intense pruritus. After the drainage of the purulent secretions, the patient developed pocket hematoma, despite of Velpeau bandages and antipruritic drugs. Being a non-compliant patient with high risk of reinfection, it was decided, four days later after hematoma evacuation, to relocate the device on the same side, beneath pectoralis major muscle. This case presents two of the device pocket surgical complications (infection and hematoma) that occurred long after the implantation procedure due to senile pruritus.

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“…However, in many patients, no cause can be found, and the "diagnosis" of senescent pruritus is made. The cause is unknown, but agerelated structural or functional changes in afferent neurons and a loss of "tone" in pain neurons leading to central disinhibition of itch traffic have been postulated [41]. Impairment of barrier function is probably also important.…”

Section: Neurogenic Itch Including Itch Associated With Systemic Dismentioning

confidence: 99%

Pathogenesis and Treatment of Pruritus

Greaves

2010

Curr Allergy Asthma Rep

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Classification of itch into four categories-pruritoceptive, neurogenic, neuropathic, and psychogenic-has proven to be of utility to clinicians and investigators. Itch is recognized to be transmitted by dedicated afferent neurons, and a matrix of cerebral cortical loci involved in perception and the desire to scratch has been recognized. This highlights the multidimensional nature of the itch sensation. Some of the many mediators of itch, especially relevant in pruritogenic itch, are the result of cross-talk between dermal mast cells and adjacent cutaneous afferents. Keratinocytes of the epidermis express many neuropeptides, and their receptors are far from passive bystanders in the neurophysiology of itch. Mediators can also act centrally (eg, opioid peptides that act on micro receptors in the central nervous system). The pathophysiology of pruritus in neurogenic itch caused by common systemic diseases is gradually being elucidated, especially in the itch of cholestasis, although the molecular basis of itching in chronic renal failure remains elusive. Better understanding of the mediators of itch and their receptors has led to the imminent development of novel anti-itch compounds, including interleukin-31 inhibitors, histamine H4-receptor antagonists, and neurokinin-1 receptor antagonists.

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Willan's itch and other causes of pruritus in the elderly

Cited by 77 publications

References 60 publications

Chronic Pruritus in the Elderly: Pathophysiology, Diagnosis and Management

Chronic Pruritus in the Elderly: Pathophysiology, Diagnosis and Management

Subpectoral pacemaker implant after repeated pocket complications due to "senile pruritus"

Pathogenesis and Treatment of Pruritus

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