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Dermatol Ther 2020 Jun 15. Epub 2020 Jun 15.

Department of Dermatology, Konya Numune State Hospital, Konya, Turkey.

Hautarzt 2020 Jul;71(7):493-499

Kompetenzzentrum Chronischer Pruritus (KCP), Klinik für Hautkrankheiten, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland.

Chronic pruritus is a common and burdensome symptom in medicine. The care of patients with chronic pruritus is very complex not only because of the high prevalence, but also because of the multifactorial character of itch and the lack of approved therapies. In addition to the main patient need to alleviate the pruritus, patients wish to find the cause of chronic pruritus. Read More

J Clin Neuromuscul Dis 2020 Jun;21(4):243-244

Neurology, University of Missouri, Columbia, MO.

BMC Neurol 2020 May 16;20(1):191. Epub 2020 May 16.

Department of Physical Medicine and Rehabilitation, Health Sciences University Ankara Training and Research Hospital, Ulucanlar street, Ankara, Turkey.

Background/objective: Notalgia paresthetica (NP) is a sensory neuropathy characterized by localized pruritus and pain, presenting with or without a well-circumscribed hyperpigmented patch in the upper back. Abnormal sensations, such as burning, numbness, and paresthesia are often present in patients with NP. In this study, we clinically and radiologically analyzed patients with NP. Read More

Rehabilitacion (Madr) 2020 Apr - Jun;54(2):142-145. Epub 2019 Dec 18.

Servicio de Rehabilitación, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.

Notalgia paresthetica is a sensory mononeuropathy caused by compression localized in the dorsal region. The condition is clinically characterised by the presence of pruritus, paresthesias and hyperalgesia associated with a hyperpigmented patch in the correspondingt dermatoma, substantially impairing quality of life. We report the cases of two patients aged between 35 and 65years with chronic symptoms and treated in our service with botulinum toxin type A in the affected areas. Read More

Dermatol Ther 2020 Apr 27:e13462. Epub 2020 Apr 27.

Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.

Numerous treatment modalities have been tried with diverse results for pruritus due to notalgia paresthetica (NP). Corticosteroids suppress ectopic neural discharges from injured nerve fibers and also have short-lived suppressive effect on transmission in normal C-fibers. Herein, we evaluated the efficacy of intralesional triamcinolone acetonide in the treatment of NP. Read More

Case Rep Womens Health 2020 Apr 30;26:e00197. Epub 2020 Mar 30.

Department of Anesthesia, Critical Case and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America.

Chronic pruritus affects up to 20% of the population; about 8% of patients suffer from neurogenic pruritus, including notalgia paresthetica (NP). This is a syndrome of benign, chronic itch of the unilateral medial border of the scapula of unknown etiology and limited treatment efficacy. Here we report the background on NP, followed by a classic case presentation of a 63-year-old woman. Read More

Ir J Med Sci 2020 Feb 21. Epub 2020 Feb 21.

Department of Public Administration, Faculty of Economics, Anadolu University, Eskişehir, Turkey.

Background: Notalgia paresthetica (NP) is a neuropathic itching condition unilaterally localized in the midscapular area. It is a common but an underdiagnosed disease, and only a few studies investigating NP etiology with a limited number of patients have been reported in the literature.

Objective: We aimed to evaluate the demographic, clinical, histopathological, neurological, and radiological findings of NP patients and investigate correlations between them and symptoms of NP to elucidate the etiology of NP. Read More

Dermatol Ther 2020 Mar 5;33(2):e13242. Epub 2020 Feb 5.

Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.

Skinmed 2019 1;17(6):370-372. Epub 2019 Nov 1.

Traditional and Complementary Medicine Application and Research Center, Hitit University, Çorum, Turkey.

Notalgia paresthetica (NP) is a common clinical disorder characterized by hyperpigmentation, pruritus, paresthesia, and/or pain, located on the back. There is no effective treatment for patients with NP. We investigated the efficacy of a product containing bee venom (0. Read More

Int J Dermatol 2020 Apr 24;59(4):e125-e127. Epub 2019 Oct 24.

Department of Dermatology, Faculty of Medicine, Selcuk University, Konya, Turkey.

Acta Clin Croat 2018 Dec;57(4):721-725

1Department of Dermatology and Venereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; 2Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia.

- Notalgia paresthetica is a common, although under-recognized condition characterized by localized chronic pruritus in the upper back, most often affecting middle-aged women. Apart from pruritus, patients may present with a burning or cold sensation, tingling, surface numbness, tenderness and foreign body sensation. Additionally, patients often present with hyperpigmented skin at the site of symptoms. Read More

Asian Spine J 2019 10 3;13(5):721-729. Epub 2019 Jun 3.

Department of Orthopedic and Spine Surgery, Apollo Hospitals, Bilaspur, India.

Study Design: Prospective study.

Purpose: To verify the feasibility and safety of outpatient microscopic lumbar discectomy (MLD) in a developing country.

Overview Of Literature: Outpatient MLD is advantageous in terms of cost effectiveness and avoidance of nosocomial infections. Read More

Stereotact Funct Neurosurg 2019 4;97(1):31-36. Epub 2019 Apr 4.

Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA,

Background: Spinal cord stimulation (SCS) is a well-established therapy for chronic pain syndromes, with growing applicability to other conditions. Restless legs syndrome (RLS) is a widespread, chronic movement disorder managed primarily and incompletely by medication, and its etiology can be classified as idiopathic or secondary.

Methods: Three patients underwent SCS implantation for chronic back and/or leg pain with concomitant targeting of RLS: (1) a 34-year-old man with sporadic RLS symptoms that strongly intensified after military-related spinal fractures, (2) a 54-year-old man with RLS likely secondary to meralgia paresthetica, and (3) a 42-year-old man with low back and right lower extremity pain after a military motor vehicle accident. Read More

J Dermatolog Treat 2020 Jun 25;31(4):424-432. Epub 2019 Apr 25.

College of Medicine, University of Central Florida, Orlando, FL, USA.

Notalgia paresthetica (NP) is a sensory neuropathy of the back characterized by a well demarcated, hyperpigmented macule or patch located medial or inferior to the scapulae. Symptoms include localized pruritus and pain, and the clinical course consists of remissions and relapses. It can be an underrecognized and difficult disease to treat since conventional treatments for pruritus in inflammatory dermatosis have variable efficacy. Read More

J Spine Surg 2018 Sep;4(3):610-615

Department of Neurosurgery, School of Medicine, University of Thessaly, Larissa, Greece.

Background: Surgical treatment of adult degenerative scoliosis (DS) always remains a challenge and often necessitates complex multilevel surgery via traditional open approaches. However, the severity of the procedure, in association with the fact that many of these patients are at an advanced age with several comorbidities, results in high rate of complications. Therefore, during the last decade, minimally invasive procedures have gained a place in the treatment of this pathology. Read More

Am J Phys Med Rehabil 2018 12;97(12):929-932

From the Physical and Rehabilitation Medicine Department, Hospital de Braga, Braga, Portugal (CMdC); and Physical and Rehabilitation Medicine Department and Pain Treatment Unit, Hospital de Braga, Braga, Portugal (FA).

Notalgia paresthetica is a rarely reported T2-T6 sensory neuropathy whose etiology and treatment are not fully established. Although it is believed to be common in dermatological practice, it remains underrecognized, underdiagnosed, and therefore underreported. This case-report provides a physical medicine and rehabilitation perspective on notalgia paresthetica diagnosis and treatment. Read More

Cutis 2018 Sep;102(3):185;186;189;190

Department of Orthopedic Surgery, St. Jude Heritage Medical Group, Fullerton, California, USA.

Notalgia paresthetica (NP) is a common, often refractory sensory neuropathic syndrome with the hallmark symptoms of localized pruritus and dysesthesia of the unilateral infrascapular region. Brachioradial pruritus (BRP) is similarly classified as a localized pruritus syndrome but of the upper extremities, typically one or both forearms. Notalgia paresthetica and BRP are both generally chronic, nonlethal, incurable conditions with intermittent remissions and exacerbation. Read More

Int J Dermatol 2018 09 17;57(9):e70-e71. Epub 2018 Jun 17.

Ankara Health Application and Research Hospital, Ankara, Turkey.

Int J Dermatol 2018 08 6;57(8):e52. Epub 2018 May 6.

Department of Dermatology, University of California San Diego, La Jolla, CA, USA.

Int J Dermatol 2018 Apr 15;57(4):388-392. Epub 2017 Dec 15.

Department of Dermatology, Alfred Hospital, Melbourne, Victoria, Australia.

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. Read More

Cureus 2017 Sep 28;9(9):e1719. Epub 2017 Sep 28.

Department of Dermatology, University of California, San Diego.

Notalgia paresthetica, a neurosensory syndrome that typically occurs on the upper back, has multiple clinical symptoms with variable degrees of expression in each individual afflicted with the condition. The involved site is usually hyperpigmented and is associated with burning, coldness, hypoesthesia, increased pain, pruritus and/or tingling. In the affected area, the number of nerve fibers may be increased and the cutaneous sensory nerves are altered secondary to localized impingement, central injury, or both. Read More

J Am Board Fam Med 2017 Nov-Dec;30(6):835-837

From the Department Family & Community Medicine, University of British Columbia, Vancouver, BC (RL); Department of Dermatology, Mayo Clinic, Scottsdale, AZ (LAS, DLS).

Notalgia paresthetica is a syndrome of unilateral, chronic pruritis that is associated with burning pain, paresthesia, numbness, and hyperesthesia localized to the medial and inferior scapula. The condition does not respond to anti-inflammatory drugs or traditional antipruritic agents and has variable responses to numerous other reported pharmacologic and nonpharmacologic therapies. Although the etiology is thought to be nerve impingement, neurologic and musculoskeletal causes are often not considered in the differential diagnosis. Read More

Am J Case Rep 2017 Nov 20;18:1225-1228. Epub 2017 Nov 20.

Department of Anesthesiology and Chronic Pain Management, University Hospital of Montreal (CHUM), Montreal, QC, Canada.

BACKGROUND Notalgia paresthetica is a neuropathic condition that manifests as a chronic itch in the thoraco-dorsal region. It is often resistant to treatment, and specific guidelines for its management are lacking. As such, we present a treatment approach with intravenous lidocaine infusions. Read More

J Can Chiropr Assoc 2017 Aug;61(2):128-144

Canadian Memorial Chiropractic College.

Objective: The purpose of this paper is to elucidate this little known cause of upper back pain through a narrative review of the literature and to discuss the possible role of the dorsal scapular nerve (DSN) in the etiopathology of other similar diagnoses in this area including cervicogenic dorsalgia (CD), notalgia paresthetica (NP), SICK scapula and a posterolateral arm pain pattern.

Background: Dorsal scapular nerve (DSN) neuropathy has been a rarely thought of differential diagnosis for mid scapular, upper to mid back and costovertebral pain. These are common conditions presenting to chiropractic, physiotherapy, massage therapy and medical offices. Read More

Int J Womens Dermatol 2017 Sep 21;3(3):131-139. Epub 2017 Jul 21.

Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT.

Laser treatment is a relatively new and increasingly popular modality for the treatment of many dermatologic conditions. A number of conditions that predominantly occur in women and that have a paucity of effective treatments include rosacea, connective tissue disease, melasma, nevus of Ota, lichen sclerosus (LS), notalgia paresthetica and macular amyloidosis, and syringomas. Laser therapy is an important option for the treatment of patients with these conditions. Read More

Int J Dermatol 2017 Sep 23;56(9):932-938. Epub 2017 Jun 23.

Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Background: Notalgia paresthetica (NP) is a disorder characterized by pruritus localized to the patient's back. Little is known about predictors of severity, duration, side, and localization.

Objective: To identify factors associated with perceived severity, duration, side, and localization of NP. Read More

Noro Psikiyatr Ars 2016 Mar 1;53(1):89-90. Epub 2016 Mar 1.

Clinic of Neurology, Derince Training and Research Hospital, Kocaeli, Turkey.

Pediatr Dermatol 2016 Sep 11;33(5):e303-5. Epub 2016 Jul 11.

Department of Dermatology, Hospital La Paz, Madrid, Spain.

Notalgia paresthetica is characterized by a hyperpigmented macular pruritic skin lesion most commonly localized unilaterally in the middle and upper back region. This condition has been reported in association with multiple endocrine neoplasia syndrome type 2A (MEN 2A) in several families; it rarely affects children and it may serve as an early marker of MEN 2A. We report a 9-year-old girl diagnosed with MEN 2A and notalgia paresthetica. Read More

Pain Med 2016 Jul;17(7):1249-1260

Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.

Objective: This article presents an evidence-based algorithm to assist primary care providers with the diagnosis and management of lateral hip and thigh pain in older adults. It is part of a series that focuses on coexisting pain patterns and contributors to chronic low back pain (CLBP) in the aging population. The objective of the series is to encourage clinicians to take a holistic approach when evaluating and treating CLBP in older adults. Read More

Pain Pract 2016 06;16(5):E90-1

Department of Pathology, University of Medicine Targu Mures, Targu Mures, Romania.

Agri 2015 ;27(4):224-5

Department of Orthopedics and Traumatology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

Ann Dermatol 2016 Feb 28;28(1):86-9. Epub 2016 Jan 28.

The Allergy Clinic, Copenhagen University Hospital Gentofte, Gentofte, Denmark.

Notalgia paresthetica (NP) is a focal neuropathic itch condition manifesting in intense chronic or recurrent episodic itch in a hyperpigmented, macular, uni- or bilateral skin area located below and/or medially to the scapulae. Achieving satisfactory relieve in NP patients is challenging. In this case-series three female NP patients were treated with 8% capsaicin patches following a spatial quantification of their alloknetic area with a von Frey filament. Read More

J Am Acad Dermatol 2016 Feb;74(2):215-28; quiz 229-30

Department of Dermatology, University of Missouri, Columbia, Missouri. Electronic address:

Dysesthesia is a generic term for a cutaneous symptom--such as pruritus, burning, tingling, stinging, anesthesia, hypoesthesia, tickling, crawling, cold sensation, or even pain--without a primary cutaneous condition in a well-defined location that is often caused by nerve trauma, impingement, or irritation. There are multiple types of dysesthesias depending on the body location and the nerves involved. While location, exact symptoms, and etiologies might vary, the underlying theme is that these conditions are of neurologic origin and have dermatologic consequences. Read More

Dermatol Online J 2016 Nov 15;22(11). Epub 2016 Nov 15.

Department of Dermatology, University of California Davis, Sacramento, CA.

We report a patient with radiation (fluoroscopic)-induced dermatitis that produced symptoms similar to notalgia paresthetica. Read More

J Eur Acad Dermatol Venereol 2016 Mar 11;30(3):452-4. Epub 2014 Nov 11.

National Skin Centre, Singapore, Singapore.

Int J Dermatol 2015 Jan 14;54(1):e49-51. Epub 2014 Oct 14.

Department of Dermatology, Second University of Naples, Naples, Italy.

An Bras Dermatol 2014 Jul-Aug;89(4):570-5

Universidade Federal do Paraná, Curitiba, PR, Brazil.

Background: notalgia paresthetica is a subdiagnosed sensory neuropathy presenting as a condition of intense itching and hyperchromic macule on the back that interferes with daily habits.

Objectives: To determine the efficacy of treatment of notalgia paresthetica using oral gabapentin, assessing the degree of improvement in itching and influence on quality of life. Moreover, to evaluate the signs and symptoms associated with notalgia paresthetica. Read More

Ann Dermatol 2014 Jun 12;26(3):392-4. Epub 2014 Jun 12.

Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.

Notalgia paresthetica refers to an isolated mononeuropathy involving chronic localized itch or paresthesia most often at the skin of the scapula or surrounding regions. There are no specific skin manifestations except those arising from chronic scratching and rubbing. The specific etiology remains unknown; however, it has been theorized that the neuropathic itch is caused by sensory nerve entrapment involving the posterior rami of the T2 to T6 nerve root. Read More

Prog Drug Res 2014 ;68:293-306

Neurogenic pain and pruritus are the common chief complaints at dermatology office visits. Unfortunately, they are also notoriously difficult conditions to treat. Topical capsaicin used as a single therapy or as an adjuvant offers a low-risk option for patients who do not achieve control on other therapies. Read More

J Am Acad Dermatol 2014 Jun;70(6):1139-41

Innovaderm Research, Montreal, Canada.

Actas Dermosifiliogr 2014 Jan-Feb;105(1):74-7. Epub 2013 Dec 27.

Servicio de Dermatología, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.

Introduction: Notalgia paresthetica is a sensory mononeuropathy that affects dorsal segments T2 to T6. It can have a significant effect on quality of life. Numerous treatments have been used with variable results. Read More

Dermatol Pract Concept 2013 Jan 31;3(1):3-6. Epub 2013 Jan 31.

Largo Medical Center, Largo, FL, USA.

Background: Notalgia paresthetica (NP) is a very common, under-recognized condition characterized by pruritus in a unilateral, dermatomal distribution in the mid-back. Chronic pruritus is sometimes accompanied by pain, paresthesias, or altered sensation to touch.

Objectives: To review the current literature with regards to the cause of NP and its most appropriate treatment. Read More

J Dermatol 2013 Jun 27;40(6):505-6. Epub 2013 Apr 27.

JAMA Dermatol 2013 Feb;149(2):200-3

Department of Dermatology, University of Pittsburgh, Pittsburgh, PA 15213, USA.

Background: Scalp dysesthesia is characterized by abnormal sensations of the scalp in the absence of any other unusual physical examination findings. The pathogenesis of this condition is unknown but has been reported in the setting of underlying psychiatric disorders. Other localized pruritic syndromes, including brachioradial pruritus and notalgia paresthetica, have been associated with pathologic conditions of the spine and have been successfully treated with gabapentin. Read More

Dermatol Ther 2013 Mar-Apr;26(2):104-9

Department of Psychosomatics and Psychotherapy, Competence Center of Chronic Pruritus, University Hospital Münster, 48149 Münster, Germany.

Chronic pruritus (CP) is a frequent symptom in the general population; in 8% of all patients, it has a neuropathic origin. CP is of neuropathic origin when nerve fiber damage is responsible for the symptom. The damage can be caused by compression or degeneration of the nerve fibers in the skin or extracutaneous in peripheral nerves or the central nervous system. Read More

Skinmed 2011 Nov-Dec;9(6):353-8; quiz 359

Department of Dermatology, University Hospital Complex of Vigo, Vigo, Spain.

Notalgia paresthetica is a neurocutaneous disorder that most commonly manifests as pruritus and a brownish macula in the patient's upper back. Pain, burning, and paresthesias to a variable degree have also been reported. Although the physiopathology of notalgia paresthetica is still obscure, it is currently considered a sensory neuropathy caused by damage to the spinal nerves. Read More

Semin Cutan Med Surg 2011 Jun;30(2):87-92

Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

Chronic itch can be caused by dysfunctions of itch-sensing neurons that produce sensory hallucinations of pruritogenic stimuli. The cellular and molecular mechanisms are still unknown. All neurological disease categories have been implicated, and neurological causes should be considered for patients with otherwise-unexplained itch. Read More

Acta Derm Venereol 2011 May;91(3):356-7