Clinical, epidemiological and therapeutic profile of patients with brachioradial pruritus in a reference service in dermatology

Abstract

This is a cross-sectional study, conducted from May to November/2014, in a dermatology reference unit, through review of medical records and interviews. In a sample of 49 patients with brachioradial pruritus, we observed higher prevalence of Caucasian (81.6%) and women (73.5 %), with a mean age of 56.1 years. Pruritus occurred in the topography of brachioradialis muscle in 87.8% of cases; 59.2% of the sample reported worsening of pruritus with sun exposure; the mean intensity of this symptom before treatment was 8.63. Therapy effectiveness was described as "very good/good" in 79.2% of cases, and for 55.3% relapses were categorized as "uncommon".

Treatment of Brachioradial Pruritus: A Systematic Review

“…The most commonly cited oral medication for BRP treatment is gabapentin with eight articles (three retrospective studies, one case series, four case reports; n=26) reporting on gabapentin efficacy. 4,5,10,19,[21][22][23][24] Effective doses range from 300 mg once daily to six times daily. 19,[21][22][23] However, side effects such as sedation and gastrointestinal upset may limit the upper limit of dosing in some patients.…”

“…5 Antidepressants, such as amitriptyline, doxepin and fluoxetine, and antipsychotics, such as risperidone, pimozide and chlorpromazine, have occasionally been used to treat BRP. 4,5,10 Two retrospective studies (n=53) noted these medications have a similar effect as gabapentin, with a majority of patients noting either "excellent" or "good" reduction in pruritus. Unfortunately, no doses were reported.…”

“…Unfortunately, no doses were reported. 4,10 Antihistamines and NSAIDs are rarely prescribed for BRP. While antihistamines are classically thought to be anti-pruritic, they are typically ineffective in BRP.…”

“…2,3,8 Retrospective studies demonstrate 34.1% to 77% of patients have worsening symptoms in summer, 48.6% to 59% note exacerbation after sun exposure, and 30% to 80.5% have cervical spine abnormalities. [3][4][5][6][7] While BRP appears to be a benign disease, it causes significant impairment in patient quality of life (QOL). 6,7,9 Typical pruritus treatments, such as corticosteroids or antihistamines, are unsuccessful in treating BRP.…”

“…After removing duplicate data (Pinto et al/Waccholz et al and Pereira et al/Stienke et al), 399 patients with BRP were included. 4,[9][10][11] Given that most data on BRP treatment comes from case series and reports, the overall quality of the evidence reviewed is low (Table 1-4).…”