Hereditary localized pruritus
Chronic sensory neuropathy causing localized itch on the upper back.
Last updated
Hereditary localized pruritus, also known as notalgia paresthetica, is a chronic sensory neuropathy characterized by localized itch, typically between the shoulder blades. It often presents with a well-circumscribed hyperpigmented patch on the back, usually on the left side below the shoulder blade.
Quick Facts
- Alternative names
- Notalgia paresthetica
- notalgia paraesthetica
- posterior pigmented pruritic patch
- subscapular pruritus
- Affected dermatomes
- T2–T6
- Common location
- Mid to upper back, left side below shoulder blade
- Primary symptom
- Pruritus (itch)
Facts from the source article.
Causes
The causes of this condition are not fully defined. It is most often seen in older persons. Spinal nerve impingement may contribute, as the posterior rami of spinal nerves T2 through T6 take a right-angle course through the multifidus spinae muscle, which may predispose them to injury. Patients may also have other conditions that increase risk of peripheral neuropathies.
Treatment
Therapy aims to control symptoms, as no cure exists. Options include local anesthetics, topical capsaicin, topical corticosteroids, hydroxyzine, oxcarbazepine, palmitoylethanolamide, and gabapentin. Paravertebral nerve block and botulinum toxin injections may also help. Low-concentration topical capsaicin can cause pain, burning, or tingling, and symptoms often return within a month of stopping.
High-concentration capsaicin (8%, Qutenza) has shown effectiveness in some cases. Hydroxyzine used daily has had considerable success. Botulinum toxin type A injections have provided long-term relief in some patients, even though the effect normally wears off in three to six months.
More in Neurocutaneous Conditions
Sources
Compiled from Wikipedia and the sources listed below. Text from Wikipedia is available under CC BY-SA 4.0; this entry is adapted from it.
- Wikipedia: Notalgia paresthetica (CC BY-SA 4.0).
- Word definitions: the , each quoted from its Wikipedia article.
Spotted an error? Know more?
Reader corrections go straight into our review queue. Suggest an edit · How this site is sourced