notalgia paresthetica

Etiology

• disease of the thoracic spine
• surgery, trauma, neuropathy, or infection (postherpetic neuralgia)
  • persistent itch on the back following spinal surgery

Pathology

• neuropathic pruritus caused by dysfunction of a peripheral nerve or central nerve
• spinal nerve impingement leading to chronic neuropathic dysesthesia.

Clinical manifestations

• localized pruritus, most commonly on the medial back around the scapula
• burning, tingling, numbness, or cold sensations
• may present with a hyperpigmented thin plaque just medial to the scapula in the area that has been chronically scratched
• absence of primary skin lesions

Management

• pharmaceutical agents
  • gabapentin
  • carbamazepine
  • topical capsaicin
  • botulinum toxin has been used with success

More general terms

• neuropathic pruritus