Neurogenic Pruritus: An Unrecognised Problem? A Retrospective Case Series of Treatment by Acupuncture

Abstract

Intractable localised segmental pruritus without a rash has been reported over the years under various titles depending on the area of the body affected. Notalgia paraesthetica and brachioradial pruritus are the two terms used for what is believed to be a form of neuropathy. The clinical observations reported here suggest that other localised cases of pruritus exist that share common clinical features, and the term neurogenic pruritus is suggested to encompass these under one clinical condition. Acupuncture has been used to treat skin conditions, of which pruritus is one symptom. This retrospective study looked at the symptomatic relief of neurogenic pruritus in 16 patients using acupuncture. In 12 cases the affected dermatomes of the body were innervated by cervical spinal nerves, seven innervated by dorsal spinal nerves and four innervated by the lumbar spinal nerves. Seven patients had areas affected by two different regions of the spine. Restricted neck or back movements were noted in patients as were areas of paravertebral spasm or tenderness of the muscles. Total resolution of symptoms as judged by VAS occurred in 75% of patients. Relapse occurred in 37% of patients within 1-12 months following treatment. Acupuncture appeared to be effective in alleviating the distressing symptom of itching in patients presenting with neurogenic pruritus.

Brachioradial pruritus as a result of cervical spine pathology: The results of a magnetic resonance tomography study

“…Several recent studies have suggested that BRP may result from cervical spine lesions such as radiculopathy, disk herniation, osteophytes, or spinal neoplasms. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] For example, Kavak and Dosoglu 20 and Fleuret et al 27 described an ependymoma located in the cervical spine that led to BRP. In a retrospective study, Goodkin et al 15 found radiographic evidence of pathological changes in the cervical spine in 50% of patients with BRP.…”

Effectiveness of Acupressure on Pruritus and Lichenification Associated with Atopic Dermatitis: A Pilot Trial

“…Recent investigations have suggested a role for acupuncture techniques in reducing pruritus, although the effectiveness of acupressure has not been Effectiveness of acupressure on pruritus and lichenifi cation associated with atopic dermatitis: a pilot trial Kachiu Cecilia Lee, investigated. [1][2][3][4] While acupuncture requires skin penetration with needles, acupressure only requires application of pressure outside the skin. Acupressure offers the advantage of painless self-application in any setting by the application of pressure to traditional acupuncture points.…”

Notalgia Paresthetica Relieved by Cervical Traction

“…4 Deep, intramuscularstimulation acupuncture was temporarily effective in 16 patients, with recurrence of symptoms between 1 and 12 months. 18 Osteopathic manipulative treatment successfully treated 1 woman with notalgia paresthetica. 19 In busy primary-care settings, providers may overlook possible biomechanical and neurologic causes of notalgia paresthetica.…”