Brachioradial pruritus (sometimes abbreviated BRP) is an intense itching sensation of the arm usually between the wrist and elbow of either or both arms. The itch can be so intense that sufferers will scratch their own skin to a bleeding condition.
The condition is becoming increasingly common, presenting in patients who are usually fair skinned and middle aged and indulge in golf, tennis, outdoor table tennis, sailing, or other leisure outdoor activities in sunny climates.
The cause is not known, although there are a few lines of thought on what causes it. No cure has been found. Many different medications and types of topical creams have been experimented with, but none seem to make any difference. The only thing that seems to help most sufferers is the application of ice to the area until the itch is diminished.
Video Brachioradial pruritus
Causes
Brachioradial pruritus (BRP) is a localized pruritus of the dorsolateral aspect of the arm. BRP is an enigmatic condition with a controversial cause; some authors consider BRP to be a photodermatosis, whereas other authors attribute BRP to compression of cervical nerve roots.
BRP may be attributed to a neuropathy, such as chronic cervical radiculopathy. The possibility of an underlying neuropathy should be considered in the evaluation and treatment of all patients with BRP.
The main cause of BRP is not known, but there is evidence to suggest that BRP may arise in the nervous system also Cervical spine disease may be an important contributing factor.
Patients with BRP may have underlying cervical spine pathology. Whether this association is causal or coincidental remains to be determined.
There is controversy regarding the cause of brachioradial pruritus: is it caused by a nerve compression in the cervical spine or is it caused by a prolonged exposure to sunlight?
In many patients, itching of the arms or shoulders is seasonal. Some patients reported neck pain.
BRP can be linked to the thyroid.
Maps Brachioradial pruritus
Treatments
- BRP Patient Testimonial: Cervical traction with a home device (used in a horizontal body position) seems to relieve some of the pressure on cervical nerves. In addition, Lidocaine 5% patches (manufactured by Watson/Actavis Pharmaceuticals) placed each evening on shoulders and arms have provided significant, beneficial, and effective relief. Patches are worn for 12 hours and help the patient to sleep at night. The benefits seem to carry over into the following day. Lastly, Aspercream with 4% Lidocaine provides on-the-spot short term relief. Effective hygiene includes cool or cold showers with only Cetaphil used on arms and shoulders.
- BRP Patient Testimonial: Some have reported relief after some suffering through the local application of capsaicin to the itchy areas. Capsaicin will cause a SEVERE BURNING SENSATION for 1-3 days after application which is made worse by heat, whether from sunlight, water, or other sources. It seems to have a white noise effect on the itching, with the itching being hidden beneath the burning sensation. I've experienced much relief after just 2-3 days of application. DO NOT UNDERESTIMATE THE BURNING SENSATION FROM THE CAPSAICIN (it will be intense) and keep away from eyes until hands have been thoroughly washed, even after possible contact.
Treatment with lamotrigine has been reported.
Treatment by acupuncture has been reported.
See also
- List of cutaneous conditions
References
Further reading
- Walcyk, Patricia J.; Elpern, D.J. (1986). "Brachioradial pruritus: a tropical dermopathy". British Journal of Dermatology. 115 (2): 177-80. doi:10.1111/j.1365-2133.1986.tb05714.x. PMID 3741783.
- Orton, D.I.; Wakelin, S.H.; George, S.A. (1996). "Brachioradial photopruritus - a rare chronic photodermatosis in Europe". British Journal of Dermatology. 135 (3): 486-7. doi:10.1046/j.1365-2133.1996.d01-1030.x. PMID 8949453.
- Dermatology 1977;195:414-5.
- Brachioradial Pruritus at eMedicine
- Veien, Niels K.; Hattel, Thais; Laurberg, Grete; Spaun, Eva (2001). "Brachioradial pruritus". Journal of the American Academy of Dermatology. 44 (4): 704-5. doi:10.1067/mjd.2001.112912. PMID 11260554.
- Henry JB. Clinical Diagnosis and Management by Laboratory Methods. Twentieth Edition. WB Saunders. 2001.
- Rosai J. Ackerman's Surgical Pathology. Ninth Edition. Mosby 2004.
- Sternberg S. Diagnostic Surgical Pathology. Fourth Edition. Lippincott Williams & Wilkins 2004.
- Robbins Pathologic Basis of Disease. Seventh Edition. WB Saunders 2005.
- DeMay RM. The Art and Science of Cytopathology. Volume 1 and 2. ASCP Press. 1996.
- Weedon D. Weedon's Skin Pathology Second Edition. Churchill Livingstone. 2002
- Fitzpatrick's Dermatology in General Medicine. 5th Edition. McGraw-Hill. 1999.
- Weiss SW and Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. Fourth Edition. Mosby 2001.
Further reading
Source of the article : Wikipedia
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