Notalgia paresthetica

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's weight loss doctor NYC
Philadelphia GLP-1 weight loss and GLP-1 clinic NYC

Notalgia paresthetica
Notalgia paresthetica rash
Synonyms
Pronounce
Specialty	Dermatology, Neurology
Symptoms	Itching, hyperpigmentation
Complications
Onset
Duration
Types
Causes	Nerve entrapment, spinal degeneration
Risks
Diagnosis	Clinical diagnosis, skin biopsy
Differential diagnosis	Eczema, psoriasis, contact dermatitis
Prevention
Treatment	Topical capsaicin, physical therapy, gabapentin
Medication
Prognosis
Frequency
Deaths

Notalgia paresthetica is a chronic sensory neuropathy characterized by localized itching, pain, and altered sensation in the upper back, typically between the shoulder blades. It is often associated with a hyperpigmented patch of skin in the affected area.

Signs and Symptoms

The primary symptom of notalgia paresthetica is a persistent itch in the upper back, usually on one side. Patients may also experience:

• Paresthesia, or abnormal sensations such as tingling or burning
• Hyperalgesia, or increased sensitivity to pain
• A well-defined area of hyperpigmentation

Pathophysiology

The exact cause of notalgia paresthetica is not well understood, but it is believed to involve nerve entrapment or irritation. The dorsal rami of the thoracic spinal nerves, particularly T2 to T6, are thought to be involved. This condition may be related to degenerative changes in the spine, such as osteophytes or herniated discs, which can compress the nerves.

Diagnosis

Diagnosis of notalgia paresthetica is primarily clinical, based on the characteristic symptoms and physical examination. Dermatologists and neurologists may be involved in the evaluation. Imaging studies, such as MRI or CT scan, may be used to rule out other causes of the symptoms.

Treatment

Treatment options for notalgia paresthetica focus on symptom relief and may include:

• Topical treatments, such as capsaicin cream or lidocaine patches
• Oral medications, including gabapentin or pregabalin
• Physical therapy and exercises to improve posture and reduce nerve compression
• Transcutaneous electrical nerve stimulation (TENS)

Prognosis

Notalgia paresthetica is a chronic condition that can persist for many years. While it is not life-threatening, it can significantly impact quality of life due to the persistent itching and discomfort. Management focuses on alleviating symptoms and improving the patient's quality of life.

See also

• Neuropathy
• Pruritus
• Hyperpigmentation
• Spinal nerve