ABSTRACT
Elderly people complain about their skin status in high proportion; this proportion may be as high as over 80% at the age of 80. They most often complain about the unsightliness of the skin, skin spots, pruritus, and stinging. Sometimes they complain about what is called “senile pruritus.” In most cases “senile pruritus” may result from dry skin conditions. Dry skin is often localized on the lower legs and the outsides of the upper arms; dryness may also occur in the face. Dry skin may develop into eczéma craquelé, especially when stressed with repeated exposure to hot water and detergents. This condition may even develop into a generalized eczema and erythroderma. Erythroderma is much more common in the elderly. The cause of erythroderma is often difficult to identify. The most common cause for erythroderma in the elderly is generalized eczema. Eczema may be related to atopic constitution or to contact dermatitis. Dry skin in the elderly may also be related to psoriasis or irritated (eczemateous) psoriasis. The incidence of psoriasis increases with age. Dry skin may also be related to T-cell lymphoma, which causes localized or generalized mycosis fungoides. The initial stage, often called parapsoriasis, is especially difficult to distinguish from eczema. A special type of mycosis fungoides, Sézary syndrome, shows erythroderma and itching and is sometimes also difficult to distinguish from generalized eczema or psoriasis. Dry skin can be an important finding in renal and hepatic diseases and in hypothyreodism, diseases, which are much more frequent in aging. Very seldomly eczéma craquelé may be an indicator of an internal malignancy.1
