I was intrigued by the discovery of anti-basement membrane zone antibodies in healthy elderly individuals as reported by Hachisuka and colleagues1 because of the theoretical possibility that such antibodies could play a role in so-called senile pruritus. In most cases of itching in the elderly, a cause, such as medication use, xerosis, skin disease, or underlying systemic illness, can be identified. By definition, the cause of senile pruritus is officially unknown,2 although some cases may have an age-related neurologic basis.3 Itching without a rash, itching with erythema or urticarial plaques but without blisters, and generalized pruritus with secondary lesions but without blisters are recognized prodromes or presentations of pemphigoid.4,5 Perhaps some cases of senile pruritus are the consequence of anti-basement membrane zone antibody formation, stuck qualitatively or quantitatively at some point between nonbinding with no disease and the point at which binding sufficient to cause frank bullous
Bernhard JD. Do Anti-Basement Membrane Zone Antibodies Cause Some Cases of 'Senile Pruritus'?. Arch Dermatol. 1997;133(8):1049–1050. doi:10.1001/archderm.1997.03890440133024
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