Stratum corneum changes in patients with senile pruritus.
Generalized pruritus in the elderly is a common and distressing problem; often there is no evidence of skin disease other than xerosis. 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. 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. 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. 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.