Pruritus Associated with Skin Xerosis: from Pathogenesis to Therapy

Pruritus is one of the most frequent complaints in dermatologic practice. It is a symptom of many dermatoses, endocrine diseases and diseases of internal organs. Among the dermatologic causes of chronic itching, xerosis (dryness) of the skin occupies a special place. It is believed that up to 85% of all cases of chronic pruritus in older patients are due to xerosis. The mechanisms of pruritus associated with dry skin are not fully deciphered. Some authors consider it pruriceptive, others neurogenic. Whichever mechanism initiates chronic itching associated with xerosis, it is characterized by the formation of a complex multilevel network of epithelial-neuro-immune interactions that are involved in the onset and maintenance of chronic itching. The mainstay of treatment of pruritus associated with xerosis is emollients. The use of products containing combinations of lipids similar to physiologic lipids, humectants leads to restoration of the skin barrier and reduction of itch intensity. The article discusses the mechanisms of skin pruritus formation in xerosis, including pruritoseptic and neurogenic, as well as approaches to the treatment of itching associated with xerosis using emollients.