Multilevel symmetric neuropathic pruritus (MSNP) presenting as recalcitrant 'generalized' pruritus
| Autor: | Rachel E. Ward, Nico Mousdicas, Jeffrey B. Travers, Vindhya Lakshmi Veerula, Navid Ezra |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Cyclohexanecarboxylic Acids Nerve root Gabapentin Dermatology Overweight Risk Assessment Severity of Illness Index Brachioradial pruritus Degenerative disc disease Cohort Studies 030207 dermatology & venereal diseases 03 medical and health sciences Age Distribution 0302 clinical medicine Dermatomal medicine Humans Amines Sex Distribution gamma-Aminobutyric Acid Aged Retrospective Studies medicine.diagnostic_test business.industry Incidence Pruritus Peripheral Nervous System Diseases Magnetic resonance imaging Middle Aged Prognosis medicine.disease Anesthesia Chronic Disease Disease Progression Quality of Life Female medicine.symptom business Body mass index 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of the American Academy of Dermatology. 75:774-781 |
| ISSN: | 0190-9622 |
| DOI: | 10.1016/j.jaad.2016.05.027 |
| Popis: | Background Chronic itch is a disruptive and disabling condition that can lead to psychological stress and depression. Objective We sought to describe an entity of generalized, symmetric, neuropathic pruritus, which we term "multilevel symmetric neuropathic pruritus," and offer possible explanations accounting for its pathogenesis. Methods A case series of 14 patients was evaluated at academic institutions from 2011 to 2015. Results All patients exhibited detectable degenerative vertebral changes, as seen by spinal x-ray or magnetic resonance imaging. In 12 of 14 (85.7%) subjects, the radiographic imaging abnormalities directly correlated with the distribution of their cutaneous findings. Twelve of 14 (85.7%) patients had cutaneous findings along the C5 to C6 and/or C6 to C7 dermatomal distributions. Eleven of 14 (78.5%) patients were overweight or obese, and 14 of 14 (100%) patients had at least 4 risk factors for the development of atherosclerosis. Twelve of 14 (85.7%) patients noted complete or near complete resolution after treatment with gabapentin (300-1200 mg daily). Limitations No healthy age-matched control group without pruritus was investigated. Conclusion A combination of multilevel degenerative disc disease of the spine, spinal nerve root impingement, and/or nerve root traction may play a pivotal role in the cause of multilevel symmetric neuropathic pruritus. |
| Databáze: | OpenAIRE |
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