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Notalgia paresthetica: a review for dermatologists.

Matthew Howard1, Lukas Sahhar2, Frank Andrews3

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Notalgia paresthetica, a chronic itchy skin neuropathy, is often underdiagnosed. This review updates clinicians on its causes, symptoms, and treatments.

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Area of Science:

  • Neurology
  • Dermatology
  • Medical Research

Background:

  • Notalgia paresthetica (NP) is an underdiagnosed chronic cutaneous neuropathy.
  • It manifests as unilateral pruritus (itching) on the midback, medial to the scapula.
  • Associated skin changes may include hyperpigmented or hypopigmented macules.

Purpose of the Study:

  • To provide an updated review of notalgia paresthetica.
  • To consolidate current knowledge on its pathogenesis, clinical features, and risk factors.
  • To detail available pharmacological and nonpharmacological management strategies.

Main Methods:

  • An extensive literature review was conducted.
  • The MEDLINE database was searched for all published works on notalgia paresthetica.
  • The review synthesizes information on diagnosis and treatment.

Main Results:

  • Current theories suggest multifactorial causes, including spinal entrapment and muscular compressive neuropathy.
  • The review covers clinical presentation, biopsy findings, and identified risk factors.
  • Various treatment options, both pharmacological and nonpharmacological, are detailed.

Conclusions:

  • Notalgia paresthetica requires increased clinical awareness due to its underdiagnosis.
  • Understanding its multifactorial etiology is key to effective management.
  • This review offers a comprehensive guide for clinicians managing this challenging condition.