ABSTRACT
Notalgia paresthetica is a neurocutaneous disorder that most commonly manifests as pruritus and a brownish macula in the patient's upper back. Pain, burning, and paresthesias to a variable degree have also been reported. Although the physiopathology of notalgia paresthetica is still obscure, it is currently considered a sensory neuropathy caused by damage to the spinal nerves. To date, no definitive treatment has been described for this disorder. Alternatives, including physical therapies and topical, systemic, and intralesional drugs, have been tested with diverse results. A review of the current knowledge on notalgia paresthetica and its treatment is provided.
Subject(s)
Hyperpigmentation/diagnosis , Hyperpigmentation/therapy , Paresthesia/diagnosis , Paresthesia/therapy , Pruritus/diagnosis , Pruritus/therapy , Skin/innervation , Humans , Hyperpigmentation/complications , Paresthesia/complications , Pectoralis Muscles/physiopathology , Posture , Pruritus/complicationsABSTRACT
The eutectic mixture EMLA cream has many medical uses, including pain relief for hemodialyzed patients prior to cannulation. Cutaneous side effects associated with its application have rarely been reported. A patient on hemodialysis developed an itchy eruption over his brachial arteriovenous fistula, where he was applying EMLA cream three times per week, prior to puncture for hemodialysis. Patch testing elicited a positive reaction to several allergens, including EMLA cream "as is" and prilocaine. The lesions resolved after topical treatment with corticosteroids.
