A Clinical Study On Geriatric Pruritus Among Patients Attending the Dermatology Outpatient Department in A Tertiary Care Center in South India

Background: Chronic pruritus, defined as persistent itching lasting more than six weeks, is a common and distressing symptom among the elderly population. With increasing life expectancy, geriatric dermatological conditions are gaining clinical importance. Pruritus in older adults is often multifactorial, arising from age-related skin changes, systemic diseases, neuropathic mechanisms, and polypharmacy. It significantly impairs quality of life by affecting sleep, emotional well-being, and daily functioning, thereby necessitating comprehensive evaluation and targeted management strategies. The aim is to assess the severity of pruritus using the 10-D pruritus scale among geriatric patients, to evaluate the association between systemic diseases and pruritus, and to determine epidemiological factors influencing pruritus in the elderly population. Material and Methods: This cross-sectional study was conducted among 104 geriatric patients aged ≥60 years attending the dermatology outpatient department of Sree Mookambika Institute of Medical Sciences, Kulasekharam, Tamil Nadu, over a period of 12–14 weeks. Data were collected using a pre-tested semi-structured questionnaire covering sociodemographic details, clinical history, and associated comorbidities. Pruritus severity was assessed using the validated 10-D pruritus scale. Clinical examination and relevant laboratory investigations, were performed where indicated. Statistical analysis was carried out using SPSS version 26, with chi-square test applied to assess associations, considering p < 0.05 as statistically significant. Results: The majority of patients belonged to the 60–69 years age group (48; 46.2%), with a slight male predominance (54; 51.9%). Dermatological causes were the most common etiology (50; 48.1%). Among dermatological conditions, infections (16; 32.0%) and eczema (13; 26.0%) predominated. Moderate pruritus was observed in 46 (44.2%) patients, followed by mild in 32 (30.8%) and severe in 26 (25.0%). A significant association was found between age and pruritus severity (p = 0.014), with increasing severity in older age groups. Comorbidities were significantly associated with systemic pruritus (p < 0.001). Conclusion: Geriatric pruritus is a multifactorial condition with dermatological causes predominating, though systemic associations remain significant. Increasing age and comorbidities contribute to greater severity. Comprehensive evaluation, including identification of underlying systemic conditions, is essential for effective management, thus improving the quality of life in elderly patients.

Keywords: Chronic pruritus; Elderly; Geriatric dermatology; Quality of life; Systemic diseases; Xerosis.