RESUMEN
Notalgia paresthetica (NP) is a sensory neuropathy characterized by chronic, localized pruritus in a circumscribed area on the upper back. Pruritus, frequently resistant to treatment, may be accompanied by pain, paresthesia, allodynia and alloknesis. There is a paucity of data in the NP literature about the use of lidocaine 5% medicated plaster. This case involves a 75-year-old woman with NP and a history of many unsuccessful local or systemic treatments. The patient was treated with lidocaine 5% medicated plaster, while other therapies were progressively retired. After 11 weeks of therapy, a significant reduction in the intensity of itching was achieved and the itching area was reduced. The patient also reported an associated improvement in her quality-of-life throughout therapy. In conclusion, lidocaine 5% medicated plaster was successful in relieving itching and other symptoms in this case of NP.
Notalgia paresthetica (NP) is a nerve disorder characterized by itching on the upper back. Sometimes the itch is so painful and intense that it can make it difficult to sleep, work and socialize, affecting quality-of-life. There are different treatments for NP and not everyone will have the same response to treatment. In this case, a woman with long-standing NP, after several unsuccessful therapies, were treated with lidocaine 5% medicated plaster, which can be applied to the skin where it hurts. After 11 weeks of therapy, an important reduction in the intensity of itching was achieved and the itching area was reduced. The patient also reported an improvement in her quality-of-life throughout therapy. In conclusion, lidocaine 5% medicated plaster was successful in relieving severe itch in this NP case.
Asunto(s)
Lidocaína , Enfermedades del Sistema Nervioso Periférico , Femenino , Humanos , Anciano , Lidocaína/uso terapéutico , Parestesia/tratamiento farmacológico , Parestesia/etiología , Prurito/tratamiento farmacológico , Prurito/etiología , Dolor/tratamiento farmacológicoRESUMEN
A case of a patient with psoriasis whose lesions resemble notalgia paresthetica is reported. We propose this association can involve important clinical and therapeutic factors to be taken into a count.
RESUMEN
La notalgia parestésica es una neuropatía sensorial caracterizada clínicamente por una mancha hiperpigmentada bien circunscrita localizada en la espalda, que afecta las áreas correspondientes a los dermatomos D2 a D6. El prurito es el síntoma más común, aunque algunos pacientes describen otras sensaciones, incluyendo ardor, parestesia, hiperestesia o dolor. Los hallazgos histopatológicos son inespecíficos. Su etiología no ha sido claramente demostrada, pero en algunos casos existe una llamativa correlación con patología de la columna vertebral, incluyendo cambios degenerativos y/o hernias del núcleo pulposo. El diagnóstico diferencial incluye la neurodermitis y la amiloidosis macular. No existe un tratamiento definitivo para la enfermedad. Se han empleado diversas terapias incluyendo capsaicina tópica, bloqueo anestésico para vertebral, oxcarbazepina, gabapentina y toxina botulínica.
Notalgia paresthetica is a sensory neuropathy characterizd clinically by a well-circumscribed hyperpigmented patch located on the back, affecting the areas corresponding to dermatomes D2-D6. Pruritus is its most common symptom, but some patients describe other sensations including burning, paresthesia, hypeesthesia or pain. Histopathological findings are not specific. The etiology of this condition has not be en clearly demonstrated but in some cases there exists a striking correlation with spinal pathology, including degenerative changes or a herniated nucleous pulposus. Differential diagnoses include neurodermitis and maclular amyloidosis There is no definitive treatment for the disease diverse therapies have been employed including topical capsaicin paravertebral local anesthetic block, oxcarbazepine, gabapentir and botulinum toxin type A.