Notalgia Paresthetica: Treatment Using Intradermal Botulinum Toxin A

Pérez-Pérez, L.; García‐Gavín, J.; Allegue, F.; Caeiro, J.L.; Fabeiro, J. M.; Zulaica, Á.

doi:10.1016/j.adengl.2013.09.003

Cited by 20 publications

(28 citation statements)

References 14 publications

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“…A more recent study of 20 patients with treatment resistant NP receiving a higher dose of botox (mean 142 units) found no statistical benefit, however . Variable results were also concluded from a further study, leaving some doubt about the cost effectiveness and efficacy of botox . The mode of action of botox in treating pruritus is believed to be by preventing the presynaptic neuron from releasing substance P .…”

Section: Discussionmentioning

confidence: 98%

Notalgia paresthetica: a review for dermatologists

Howard

Sahhar

Andrews³

et al. 2017

Int J Dermatology

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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.

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Section: Discussionmentioning

confidence: 98%

Notalgia paresthetica: a review for dermatologists

Howard

Sahhar

Andrews³

et al. 2017

Int J Dermatology

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“…8 Although it appears to be beneficial for pruritus, treatment with intradermal botulinum toxin A has shown variable results in small patient series. 3,7 In a case series of seven patients, topical tacrolimus resulted in reduction in itch intensity and/or frequency; however, the symptoms generally recurred when the treatment was discontinued. 5 Topical corticosteroids are widely used, albeit relatively inefficient unless secondary inflammation accompanies NP.…”

Section: Resultsmentioning

confidence: 99%

“…[1][2][3] It is a model example for neuropathic itch and characterized by pruritus on the back that may be accompanied by pain and paresthesias, such as numbness, tingling, or stinging. 2,3 In cases with mild pruritus, there are no clinically apparent skin changes that usually occur due to chronic rubbing or scratching. In more severe or chronic cases, a unilateral (but often bilateral) tan to brown macule on the back may be seen.…”

Section: Introductionmentioning

confidence: 99%

Intralesional triamcinolone acetonide in notalgia paresthetica: Treatment outcomes in five patients

Özcan

Seckın

Kibaroğlu

et al. 2020

Dermatologic Therapy

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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. The medical reports of five patients who had been diagnosed with NP and treated with intralesional triamcinolone acetonide injections were retrospectively evaluated. Triamcinolone acetonide solution was injected intradermally (10 mg/mL; 0.1 mL/cm2) every 3 weeks for a maximum of four treatments. The severity of itch was scored by the patients on a combined numerical and visual analogue scale. After treatment, reduction in itch severity scores varied between 33% and 100%.

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“…Thus, targeting these SNARE proteins should break the crosstalk link between sensory neurons and skin cells. In this perspective, SNARE‐inactivating agents, such as botulinum neurotoxins, have shown promising in certain itchy diseases which include lichen simplex chronicus, psoriasis and rosacea, meralgia paresthetica, and post‐burn (Akhtar & Brooks, ; Boozalis, Sheu, Selph, & Kwatra, ; Heckmann, Heyer, Brunner, & Plewig, ; Perez‐Perez et al, ; Salardini, Richardson, & Jabbari, ; Wallengren & Bartosik, ; Weinfeld, ; Zanchi et al, ). Altogether, these findings highlight the importance of SNARE as a therapeutic target in the treatment of chronic itch diseases.…”

Section: Potential Therapeutic Targets For Bnp Signalling In Itchmentioning

confidence: 99%

Interventions in the B‐type natriuretic peptide signalling pathway as a means of controlling chronic itch

Meng

Chen

Wang

2020

British J Pharmacology

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Chronic itch poses major health care and economic burdens worldwide. In 2013, B‐type natriuretic peptide (BNP) was identified as an itch‐selective neuropeptide and shown to be both necessary and sufficient to produce itch behaviour in mice. Since then, mechanistic studies of itch have increased, not only at central levels of the spinal relay of itch signalling but also in the periphery and skin. In this review, we have critically analysed recent findings from complementary pharmacological and physiological approaches, combined with genetic strategies to examine the role of BNP in itch transduction and modulation of other pruritic proteins. Additionally, potential targets and possible strategies against BNP signalling are discussed for developing novel therapeutics in itch. Overall, we aim to provide insights into drug development by altering BNP signalling to modulate disease symptoms in chronic itch, including conditions for which no approved treatment exists.

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Notalgia Paresthetica: Treatment Using Intradermal Botulinum Toxin A

Abstract: Botulinum toxin A appears to be a safe therapeutic option for patients with notalgia paresthetica. However, data currently available come from small patient series, making it difficult to draw definitive conclusions regarding the true efficacy and long-term effects of this treatment.

Cited by 20 publications

References 14 publications

Notalgia paresthetica: a review for dermatologists

Notalgia paresthetica: a review for dermatologists

Intralesional triamcinolone acetonide in notalgia paresthetica: Treatment outcomes in five patients

Interventions in the B‐type natriuretic peptide signalling pathway as a means of controlling chronic itch

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