Notalgia Paresthetica

Key Points
Skin condition typically affecting the skin of the upper back, near the shoulder blades
Caused by minor nerve irratation in the back
Consists of intermittet or constant itching, stinging or burning and sensation of the affected area

Notalgia paresthetica is a skin condition which typically affects the skin of the upper back, near the shoulder blades. The condition presents as severe itching and/or changes of sensation in the affected area. Scratching may lead to areas of scarring, hyper- or hypopigmentation, and changes of lichen simplex.

Notalgia paresthetica is caused by damage to minor nerves in the upper back which transmit sensation.

Differential Diagnosis (Other conditions with similar appearance)
Arthropod bite reaction
Lichen Simplex Chronicus
Dermatitis
Neurodermatitis
Postinflammatory Hyperpigmentation
Prurigo nodularis
Tinea Corporis
Tinea Versicolor
Shingles
Xerosis

Lichen amyloidosis

Diagnosis
Key Points
Diagnosis based on clinical examination and symptoms
Skin biopsy may be performed to rule out other conditions

Notalgia paresthetica is typically diagnosed based on a clinical examination of symptoms. A skin biopsy may be performed to rule out other, similar appearing conditions.

Treatment
May not always respond to treatment
*Several therapies exist, with varying effectiveness
OTC Options: Lotions containing camphor or menthol; capsaicin cream

Notalgia paresthetica may not always respond to treatment. However, several therapies have shown some success in treatment, including lotions containing camphor or menthol, local topical anesthetics, capsaicin cream, amitriptyline, electrical nerve stimulation, botulinum toxin, and gabapentin.