Brachioradial pruritus

Brachioradial pruritus

Chris Schach

Author Bio -

Key Points
*Chronic itching condition in the skin on one or both arms
*Caused by nerve damage of various forms
*Sun exposure also implicated
*Consists of itchy skin in the mid-arm area, which appears normal

Brachioradial pruritus is a condition in which the skin of one or both arms, specifically often the mid-arm, experiences severe itching. While skin may initially appear normal, attendant conditions which arise from scratching can manifest themselves. These include Purpura, bruising, brown or White marks (hyper-/hypopigmentation), Eczema, and scars.

Brachioradial pruritus is generally attributed to various forms of nerve damage, usually cervical in nature (including osteoarthritis, spinal tumors, and nerve compression). Excessive sun exposure has also been implicated in causing the condition, due to its increased occurrence in sunny climates and the areas of the body which it affects.

    Differential Diagnosis (Other conditions with similar appearance)

Atopic Dermatitis
Neurotic excoriations
Notalgia paresthetica
Zoster sine herpete

Diagnosis
Key Points
*Diagnosis based on appearance of symptoms
*Skin biopsy, imaging and radiological testing may be performed to rule out other conditions and to confirm diagnosis

Brachioradial pruritus is initially diagnosed on the appearance of symptoms, but other testing is required to determine the causative factor, including radiological, imaging, nerve testing, and Skin biopsy

Treatment
*Treatment is not always successful
*Goal of treatment is to prevent further occurrence, treat causative condition, and lessen symptoms
*Some OTC options are available for lessening symptoms
OTC Options: Sunscreen, protective clothing, cooling lotions (camphor, menthol)

The main goal in treating Brachioradial pruritus is two-fold: alleviating symptoms and treating the causative condition. Cooling lotions such as camphor and menthol, in addition to local anaesthetic creams can assist in relieving itching. Once the causative condition is identified, a variety of treatments are available, depending on diagnosis. In most cases, this involves treating nerves themselves, including cervical spine manipulation, Capsaicin cream, amitriptyline, and anticonvulsants. It is recommended that affected persons avoid excessive sun exposure.

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