HistoryThis section has been translated automatically.
Branch Vazaturov 1934
DefinitionThis section has been translated automatically.
Rare isolated mononeuropathy (neuropathic pruritus form) of unexplained etiology.
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EtiopathogenesisThis section has been translated automatically.
Damage to the primary branches of rami posteriores of unknown cause. Discussed are mechanical irritations and damage due to traumatic or degenerative changes of the affected spinal segments. The pigmentation of the area is understood as a stimulus response to constant rubbing at this site.
ManifestationThis section has been translated automatically.
About 70% of those affected are women. The average age of the disease is 57 years (25-80 years).
LocalizationThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
In studies with larger collectives, the symptoms of "localized pruritus of varying intensity" and a circumscribed, blurred, brown-grey patch of skin are described (probably caused reactively by rubbing and chafing of the affected areas). Furthermore, (less frequently) intermittent pain (30%), paraesthesia (28%) and hyperaesthesia (11%) are reported.
Radiologically, degenerative changes and/or nucleus pulposus hernias are found in the spinal column sections of the affected segments (most frequently Th4 and C7) in about 80% of patients.
HistologyThis section has been translated automatically.
In a larger study histologically 71.4% showed single cell necroses in the epidermis, 74.3% showed epidermal hyperpigmentation and 80% showed dermal hyperpigmentation.
Amyloid deposits in the papillary body were found in 11.4% of patients. 5.7% of the patients had none of the histological features mentioned above.
The number of peripheral nerves is significantly reduced in lesional skin.
Differential diagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
The best results are achieved with 0.025-0.05% capsaicin ointment (e.g. dolenone, capsamol) 3-5x/day over a treatment period of several months. Application of capsaicin is unpleasant due to burning, itching etc. in the first days (inform the patient!).
Improvement can also be achieved with local anaesthetic creams (e.g. EMLA cream).
Treatments with antipruriginous substances such as camphor or menthol (Pruricalm®) can be tried.
In other collectives, success could be achieved with anticonvulsants (e.g. gabapentin).
Progression/forecastThis section has been translated automatically.
Note(s)This section has been translated automatically.
The term is derived from the Greek (noton=back - algie=pain).
LiteratureThis section has been translated automatically.
- Astvazaturov M (1934) On paresthetic neuralgia and a special form of it - Notalgia parästhetica. Dt Z Nervenheilkd 133: 188-196
- Cerroni L et al (1993) Notalgia paresthetica, posterior pigmented pruritic patch and macular amyloidosis. Three stages of a disease. dermatologist 44: 777-780
- Huesmann T et al (2012) Notalgia paraesthetica: a descriptive two-cohort study of 65 patients from Brazil and Germany. Acta Derm Venereol 92:535-540
- Inaloz HS et al (2002) Notalgia paresthetica with a significant increase in the number of intradermal nerves. J Dermatol 29: 739-743
- Layton AM et al (1991) Notalgia paraesthetica - report of three cases and their treatment. Clin Exp Dermatol 16: 197-198
- Poet E (1992) Treatment of notalgia paresthetica with capsaicin. Cutis 49: 335-336
- Metz M et al (2011) Treatment of notalgia paraesthetica with an 8% capsaicin patch. Br J Dermatol 165:1359-1361
- Savk O et al (2005) Investigation of spinal pathology in notalgia paresthetica. J Am Acad Dermatol 52:1085-1087
- Savk E et al (2002) Immunohistochemical findings in notalgia paresthetica. Dermatology 204: 88-93
- Savk E et al (2000) Notalgia paresthetica: a study on pathogenesis. Int J Dermatol 39: 754-759
Incoming links (8)Amyloidosis macular cutaneous; Brachioradial pruritus; Hereditary localized pruritus; MEN 3; Menthol solution 1%; Meralgia paraesthetica; Peculiar spotty pigmentation; Puzzling posterior pigmented pruritic patches;
Outgoing links (8)Amyloidosis macular cutaneous; Gabapentin; Hyperpigmentation postinflammatory; Leprosy (overview); Lichen amyloidosis; Lichen simplex chronicus; Menthol; Rem syndrome;
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.