Symptoms of Notalgia Paresthetica May Be Explained by Increased Dermal Innervation

Springall, David R.; Karanth, Subramanya; Kirkham, N.; Darley, C.R.; Polak, Julia M.

doi:10.1111/1523-1747.ep12481889

Cited by 87 publications

(65 citation statements)

References 37 publications

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“…The same was true for the amount of neuropeptide immunoreactivity. Our findings appear to be not in accordance with the report of Springall et al [4], in which they state that the distribution of neuropeptide immunoreactivity in NP skin is the same as in normal skin but there is a significant increase in the number of PGP-9.5- and S-100-immunoreactive nerve fibers. At this time, we cannot offer a satisfactory explanation for this discrepancy between our results and those of Springall et al We can only speculate that their observation of increased innervation and the very valuable demonstration of epidermal nerves could be a result of their use of a modified indirect immunofluorescence method.…”

Section: Discussioncontrasting

confidence: 99%

“…Factors implicated include a hereditary component, increased dermal innervation, neurotoxicity of certain chemicals and spinal nerve injury due to trauma or entrapment [4, 9, 11, 12, 13, 14]. …”

Section: Discussionmentioning

confidence: 99%

“…Substance P is among the neuropeptides detected in sensory nerves of the skin and VIP is known to be present in cutaneous autonomic nerves. PGP 9.5 has been reported as the best general neural marker, and S-100 protein is accepted as a good marker of glial tissue and Schwann cells [4, 21, 22, 23]. …”

Section: Discussionmentioning

confidence: 99%

“…First defined by Astvatsaturov in 1934, NP is characterized by pruritus on the back occasionally accompanied by pain, paresthesia and/or hyperesthesia [1, 2, 3]. The dermatological finding which consists of a well-circumscribed hyperpigmented patch is thought to be secondary to the chronic rubbing and scratching due to the pruritus [4, 5, 6]. The pathogenesis of NP is not yet completely elucidated, and investigational studies about this entity are rare [4, 7, 8, 9, 10].…”

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical Findings in Notalgia paresthetica

et al. 2002

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Background: Notalgia paresthetica (NP) is a sensory neuropathy the pathogenesis of which is not yet completely elucidated. Objective: The aim of this study was to investigate the histopathological changes in NP with special emphasis on cutaneous innervation. Methods: Along with site-matched biopsies from 5 healthy individuals, lesional skin biopsies from 14 cases of NP and biopsies from contralateral nonlesional skin in 9 of these cases were stained with hematoxylin-eosin and Congo red. For immunohistochemical analysis, all samples were stained with two general neural markers (S-100 protein and protein gene product 9.5) and two neuropeptides (vasoactive intestinal polypeptide and substance P). Results: Light microscopy was compatible with postinflammatory hyperpigmentation. Immunohistochemistry did not reveal a significant difference in the staining pattern of lesional skin and control tissue (p > 0.05). Although not reaching statistical significance, the percentage of cases which showed no staining was higher in the group of patients with more chronic NP. Conclusion: The finding of less immunohistochemical staining in cases with more chronicity could be of clinical importance and is worth investigating further.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical Findings in Notalgia paresthetica

et al. 2002

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“…Others have suggested that NP may be explained by increased dermal innervation. 2 Investigations are not helpful in confirming the pathogenesis. Necrotic keratinocytes were a uniform finding on the H&E stained biopsy specimens of all the patients reported by Weber and Poulos.…”

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confidence: 99%

Notalgia Paresthetica - A Case Report

Isaac

1994

Annals of Saudi Medicine

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Notalgia paresthetica (NP) is a rarely reported dermatologic condition characterized by focal intense itching/burning, hypoesthesia and, at times, pigmentation in a patch on the medial scapular border.I wish to report a case of NP which to my knowledge is the first case reported from Saudi Arabia. The patient was a healthy 35-year-old Saudi female who presented with an eight year history of intractable itching on her left upper back. Oral antihistamines and topical steroids were of no avail. Examination revealed a pigmented and rippled patch over the left posterior thorax, with diminished pinprick sensitivity corresponding to an area from T2 to T6 thoracic dermatomes. A hematoxylin and eosin (H&E) stained biopsy specimen showed mild acanthosis, a few necrotic epidermal keratinocytes and pigmentary incontinence. Congo red staining was negative for amyloid. Topical and intralesional steroids, oral antihistamines and cryotherapy were administered without appreciable effect. She was then tried on 5% lignocaine ointment under polyethylene occlusion daily for a period of eight weeks with partial relief of her symptoms.NP, first described by Astvatsaturov, is an isolated sensory neuropathy of posterior rami of thoracic nerves T2 through T6. In addition to intense pruritis, a few patients have complaints of "tingling" and hyperalgesia with tenderness on the spinous processes.1 Sensation to light touch, temperature, and vibration may be normal or abnormal and hypoesthesia to pinprick may be noted.

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TRPV1 Agonist Approaches for Pain Management

Bley

2010

Vanilloid Receptor TRPV1 in Drug Discovery

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Symptoms of Notalgia Paresthetica May Be Explained by Increased Dermal Innervation

Cited by 87 publications

References 37 publications

Immunohistochemical Findings in Notalgia paresthetica

Immunohistochemical Findings in Notalgia paresthetica

Notalgia Paresthetica - A Case Report

TRPV1 Agonist Approaches for Pain Management

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