Notalgia paresthetica: a review for dermatologists

Abstract

Notalgia paresthetica (NP) is an underdiagnosed condition that presents with unilateral pruritus medial to the scapula on the midback with or without an associated hyperpigmented or hypopigmented macule. There is a paucity of recent reviews on this chronic cutaneous neuropathy in peer-reviewed journals. Current theories propose the condition is likely multifactorial, including spinal entrapment and muscular compressive neuropathy. An extensive literature review was performed by searching the MEDLINE database to review all published works on notalgia paresthetica. This review will provide a useful update for clinicians on the pathogenesis, clinical features, biopsy features, risk factors, and management options for this condition including pharmacological and nonpharmacological methods detailing published treatment options to date for this difficult to treat condition.

Gabapentin treatment in notalgia paresthetica: a preliminary report

“…The pathogenesis remains unclear; however, it is most likely an entrapment syndrome involving the posterior rami of T2–T6 nerve roots sometimes associated with degenerative changes of the vertebrae. Other theories involve hereditary predisposition, increased dermal innervation, or neurotoxicity because of certain chemicals …”

“…As stated in the excellent review by Howard et al ., the treatment of NP is challenging. The condition is usually refractory to standard itch‐relieving medications.…”

Notalgia paraesthetica – Ein Review mit Fallbeispiel

“…Notalgia paraesthetica, eine zirkumskripte juckende Dermatose im Bereich Th2 -Th6 unterhalb und medial des Schulterblattes, ist fast immer unilateral lokalisiert. Typisch sind Empfindungen wie Juckreiz, Brennen, Kribbeln, Hyperästhesien, jedoch auch Hypästhesien und Schmerzen [1]. Weiterhin sind häufig eine verminderte Sensitivität für leichte Berührungen, Temperaturen und Druck.…”

An alternative in the treatment of notalgia paresthetica: neural therapy

“…We read with interest the recently published article entitled “Notalgia paresthetica: a review for dermatologists” by Howard et al . The authors have evaluated the pathogenesis and treatment options for notalgia paresthetica (NP).…”

“…NP treatment is especially multidisciplinary. Many systemic and topical medicines are used in the treatment . However, after review of the MEDLINE database, no specific literature surrounding neural therapy use in NP was found.…”