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Brachioradial pruritus in a 52-year-old woman: A case report
Amnon A Berger1, Ivan Urits1, Vwaire Orhurhu2
1Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, United States.
Brachioradial pruritus is a specific subtype of neuropathic pruritus that commonly presents in women. This condition is a type of neurological itch that mostly involves the dorsal forearm. It is more common in fair-skinned females, is exacerbated by exposure to bright sunlight or ultraviolet radiation (UVR), and is associated with degenerative changes in the cervical spine. Diagnosis is difficult, and is usually delayed for 2-3 years. We describe a patient who suffered brachioradial pruritus for many years and was misdiagnosed by multiple specialists until she presented to our pain clinic. The patient had undergone invasive diagnostic testing by previous specialists but this had not led to diagnosis. After a thorough history and exam, the diagnosis of brachioradial pruritus was considered and the patient was treated with anticonvulsant medications, as these have been shown to be effective in this condition. This case is of interest to all physicians treating female patients as consideration of this diagnosis can avoid unnecessary invasive diagnostic testing.
Brachioradial pruritus is a specific subtype of neuropathic pruritus that commonly presents in women. This condition is a type of neurological itch that mostly involves the dorsal forearm. It is more common in fair-skinned females, is exacerbated by exposure to bright sunlight or ultraviolet radiation (UVR), and is associated with degenerative changes in the cervical spine. Diagnosis is difficult, and is usually delayed for 2-3 years. We describe a patient who suffered brachioradial pruritus for many years and was misdiagnosed by multiple specialists until she presented to our pain clinic. The patient had undergone invasive diagnostic testing by previous specialists but this had not led to diagnosis. After a thorough history and exam, the diagnosis of brachioradial pruritus was considered and the patient was treated with anticonvulsant medications, as these have been shown to be effective in this condition. This case is of interest to all physicians treating female patients as consideration of this diagnosis can avoid unnecessary invasive diagnostic testing.
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