Notalgia paresthetica.

Abstract

This is a 40-year-old woman with itching
and burning sensation on the back. The symptoms started
3 years before and had an intermittent course with
symptomatic periods of approximately 1 month, 5-6 times
a year, independent of the season. The itching and
burning occurred with intolerable crisis even during her
working time. There was no history of atopy or drug intake.
A spinal MRI showed no significant abnormalities.
The physical examination showed on the right subscapular
region an oval, 12 cm x 6 in size, hyperpigmented
area (Fig. 1), extending from the vertebral region
to the scapula. The limits of the patch were not sharp
due to the presence of apparently follicular hyperpigmentation.
Especially on its medial border, the skin was
lichenified due to the presence of micropapules (inset
Fig. 1). The final diagnosis was notalgia paresthetica
and topical capsaicin was prescribed.