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Disease Profile

Notalgia paresthetica

Prevalence
Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.

Unknown

Age of onset

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ICD-10

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Inheritance

Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease

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Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype

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X-linked
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.

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X-linked
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder

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Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.

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Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.

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Not applicable

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Summary

Notalgia paresthetica is a common chronic, localized itch, that usually affects patches of skin on the upper back. Occasionally it can be more widespread and involve other parts of the back, the shoulders and upper chest. People feel both the sensation of an itch and paresthesia (a sensation of tingling, pricking, or numbness of the skin). There are no signs on the skin except for signs of chronic scratching and rubbing. Amyloid deposits (a collection of a specific type of protein) may be found in skin biopsies, but this is thought to be a secondary event. The cause of the itch in notalgia paresthetica may be due to the compression of spinal nerves by bones or muscles as the nerves emerge through the vertebrae to the back muscles. Sometimes degenerative changes in the area of the vertebrae that innervate the affected back muscles can be seen, but not always. Symptoms of notalgia paresthetica may respond to topical capsaicin treatment.[1][2]

Treatment

There is no current treatment for notalgia paresthetica (NP) that is consistently effective. Evaluation and treatment of NP will often involve a multidisciplinary team of specialists. First-line therapy for NP will usually include treatment of the underlying spinal disease by orthopedic surgeons or physical therapists. Topical therapies may include steroid creams, tacrolimus, or capsaicin. Additional therapies have included botulinum toxin injections, gabapentin, physical therapy, nerve blocks, and transcutaneous electrical nerve stimulation (TENS). Some have suggested that a combination of approaches, such as medication along with muscular rehabilitation exercises, may work best. [3][4][5]

Learn more

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • DermNet NZ is an online resource about skin diseases developed by the New Zealand Dermatological Society Incorporated. DermNet NZ provides information about this condition.
  • Skin Sight provides more information about notalgia paresthetica. Click through the different sections on this condition using the bottom right hand buttons.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Notalgia paresthetica. Click on the link to view a sample search on this topic.

References

  1. Misery, Laurent. What is Notalgia paresthetica?. Dermatology. 2002;
  2. Greaves, Malcom W. Pathophysiology and Clinical Aspects of Pruritus. In: Freedberg, Irwin, et.al.. Fitzpatrick's Dermatology in General Medicine, 6th Edition. United States: McGraw-Hill; 2003; 1:398.
  3. Alai, Ally. Notalgia Paresthetica. Medscape. July 10, 2018; https://emedicine.medscape.com/article/1599159-overview.
  4. Howard M, Sahhar L, Andrews F, Bergman R, and Gin D. Notalgia paresthetica: a review for dermatologists. Int J Dermatol. April, 2018; 57(4):388-392. https://www.ncbi.nlm.nih.gov/pubmed/29243804.
  5. Robbins BA, Ferrer-Bruker SJ. Notalgia Paresthetica. StatPearls [Internet].. Oct 27, 2018; https://www.ncbi.nlm.nih.gov/books/NBK470597.

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