Two new diagnoses? Neurological itch on the arm and back

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"Two new diagnoses? Neurological itch on the arm and back."

I heard about these on a BBC Inside Health podcast and, not knowing about them thought you may be interested.1 They are Brachioradial pruritus (BRP) and Notalgia paraesthetica. The origins seem to be neurological rather than dermatological.

Brachioradial pruritus is a condition where itch, burning, stinging, tingling and/or changed sensation arise in the areas of skin on either or both arms.2

Notalgia paraesthetica is characterised by intense itch (pruritus) on the medial border of one scapula or both.3 This itch can be intermittent or continuous. It is unrelieved by scratching, although the scratching and rubbing may be pleasurable.

Their treatments overlap: Cooling lotions prn (camphor and menthol), electrical cutaneous nerve field stimulation, capsaicin cream, local anaesthetic creams, amitriptyline taken at night, gabapentin and pregabalin and topical ketamine and amitriptyline has been reported to provide rapid relief for BRP. Some manual therapies may be helpful.2,3

References:

  1. Podcast: Statins in the media, Unusual neurological itch, The hunger hormone, Viagra. Click here 
  2. DermNet: Brachioradial pruritis. Click here
  3. DermNet: Notalgia paraesthetica. Click here

    Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.


    As published in NZ Doctor 14/09/2016