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Neuropathic itch (itching or pruritus) arises from a pathology located at any point along the afferent pathway of the nervous system. It may be related to damage to the peripheral nervous system, such as in postherpetic neuropathy, brachioradial pruritus or notalgia paresthetica. It has many clinical features similar to neuropathic pain. Patients complain of itching, which is associated with burning sensation, aching, and stinging. Brachioradial pruritis (BP) is an intense itching sensation of the arm, usually between the shoulder and elbow of one or both arms. It is an enigmatic condition with a controversial etiology; some authors consider BP to be a photodermatosis, whereas other authors attribute BP to compression of cervical nerve roots. Notalgia paresthetica is an isolated mononeuropathy involving the skin over or near the scapula. Patients have a pruritus on the mid-upper back. The treatment is usually difficult, but capsaicin and local analgesic agents are the options of choice. Brachioradial pruritus and notalgia paresthetica are often unrecognized neurocutaneous conditions and therefore, a thorough history and physical examination are of utmost importance to distinguish symptoms and apply accurate therapeutic options. Sažetak Savremeni koncept: Neuropatski pruritus (svrab) povezan je s patološkim procesom koji može da se pojavi na bilo kojoj tački duž aferentnog toka nervnog sistema, a mogu da ga prouzrokuju povrede perifernog nervnog sistema. Etiopatogeneza: Mogu da ga prouzrokuju povrede perifernog nervnog sistema, kao što je slučaj kod postherpetične neuropatije, brahioradijalni pruritus i notalgija parestetika. Kliničke osobenosti: Mnoge kliničke osobine neuropatskog svraba slične su osobinama neuropatskog bola. Bolesnici se žale na svrab udružen sa žarenjem, probadanjem i jakim bolom. Brahioradijalni pruritus: Predstavlja intenzivan svrab koji se najčečće javlja između ramena i lakta jedne ili obe ruke. To je zagonetno stanje sa kontroverznim uzrocima; neki autori smatraju da je brahioradijalni pruritus fotodermatoza, dok ga drugi smatraju posledicom kompresije cervikalnih nervnih korenova. Notalgija parestetika: Ovo je posebna mononeuropatija koja zahvata kožu iznad ili u blizini skapule. Oboleli se žale na svrab gornjeg i središnjeg dela leđa. Lečenje: Obično je teško, dok Capsaicin i lokalni analgetici predstavljaju terapiju izbora. Zaključak: Brahioradijalni pruritus i notalgija parestetika su patološka stanja koja često nisu prepoznata i zbog toga je veoma važno uzeti detaljnu istoriju bolesti i izvršiti detaljan klinički pregled radi prepoznavanja simptoma i primene odgovarajućih terapijskih opcija.

serbian journal of dermatology and venereology/serbian journal of dermatology and venerology

Neuropathic itch caused by nerve root compression: brachioradial pruritus and notalgia paresthetica / Neuropatski pruritus (svrab) prouzrokovan kompresijom nervnih korenova - brahioradijalni pruritus i nostalgija parestetika