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Haney B. Notalgia paresthetica: An underdiagnosed condition in primary care. Nurse Pract 2021; 46:40-46. [PMID: 34424886 DOI: 10.1097/01.npr.0000769752.50576.d0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Notalgia paresthetica is a perplexing diagnosis in the primary care setting. Chronic itching, paresthesia, or pain causes discomfort in patients who suffer with notalgia paresthetica and it is thought to be a common but underdiagnosed condition. Recognition of this dermatologic condition can lead to reassurance and relief for affected patients.
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Affiliation(s)
- Beth Haney
- Beth Haney is an NP at UCI Student Health Center, Irvine; Yorba Linda City Councilwoman; and CEO, owner, and NP at Luxe Aesthetic Center, Yorba Linda, Calif
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Şenel E, Holt S, Sabancılar E, Sabancılar Z, Doğruer Şenel S. The etiology of notalgia paresthetica: a descriptive study of 117 patients. Ir J Med Sci 2020; 189:1311-1316. [PMID: 32086681 DOI: 10.1007/s11845-019-02133-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Notalgia paresthetica (NP) is a neuropathic itching condition unilaterally localized in the midscapular area. It is a common but an underdiagnosed disease, and only a few studies investigating NP etiology with a limited number of patients have been reported in the literature. OBJECTIVE We aimed to evaluate the demographic, clinical, histopathological, neurological, and radiological findings of NP patients and investigate correlations between them and symptoms of NP to elucidate the etiology of NP. METHODS One hundred and seventeen consecutive patients diagnosed with NP were included and assessed in a multidisciplinary and prospective manner. We recorded demographic and clinical data and obtained a skin biopsy from the pruritic or hyperpigmented region. Pruritus severity was assessed by visual analogue scale (VAS). All patients were evaluated neurologically with magnetic resonance imaging. RESULTS The mean age of the patients was 47.08 ± 12.28 years. The disease was more common in females (87.2%). Statistical analysis revealed that VAS scores were independent of the age, gender, and skin type of the patient. We found no significant difference in VAS scores between NP patients with or without comorbidities. Vertebral pathologies detected by MRI and amyloid deposition revealed in histopathology were not among the main factors affecting VAS scores. STUDY LIMITATION Since consecutive patients enrolled into the study, we could not include equal number of male and female patients. CONCLUSION We found no correlation between symptom severity and findings from neurological and histopathological evaluations. Further microneurological studies should be carried out to elucidate the etiology of NP.
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Affiliation(s)
- Engin Şenel
- Department of Dermatology and Venereology, Faculty of Medicine, Hitit University, Çorum, Turkey.
| | - Shaun Holt
- School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
| | - Emine Sabancılar
- Department of Dermatology and Venereology, Faculty of Medicine, Hitit University, Çorum, Turkey
| | - Zafer Sabancılar
- Department of Neurosurgery, Faculty of Medicine, Hitit University, Çorum, Turkey
| | - Seher Doğruer Şenel
- Department of Public Administration, Faculty of Economics, Anadolu University, Eskişehir, Turkey
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Caccavale S, Caccavale T, La Montagna M. A Case of Morphea Following Radiotherapy for an Intracranial Tumor: An Example of Isoradiotopic Response. Indian J Dermatol 2017; 62:92-93. [PMID: 28216732 PMCID: PMC5286761 DOI: 10.4103/0019-5154.198043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Stefano Caccavale
- Department of Dermatology, Second University of Naples, Naples, Italy. E-mail:
| | - Tobia Caccavale
- Department of Cardiovascular Surgery and Transplant, Second University of Naples, Naples, Italy
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Caccavale S, Caccavale T, La Montagna M. Pustular Psoriasis Occurring on the Striae Distensae: An Umpteenth Example of Immunocompromised Cutaneous District. Indian J Dermatol 2016; 61:565-6. [PMID: 27688451 PMCID: PMC5029247 DOI: 10.4103/0019-5154.190106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Stefano Caccavale
- Department of Dermatology, Second University of Naples, Naples, Italy. E-mail:
| | - Tobia Caccavale
- Department of Cardiovascular Surgery and Transplant, Second University of Naples, Naples, Italy
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Caccavale S, Caccavale T, La Montagna M. Lichen planus after rabies vaccination: an example of isovaccinetopic response. Int J Dermatol 2016; 56:e40-e41. [PMID: 27653743 DOI: 10.1111/ijd.13411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 05/02/2016] [Accepted: 06/06/2016] [Indexed: 12/01/2022]
Affiliation(s)
| | - Tobia Caccavale
- Department of Cardiovascular Surgery and Transplant, Second University of Naples, Italy
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Caccavale S, Di Mattia D, Ruocco E. Loco-regional immune default: The immunocompromised district in human and comparative dermatology. Clin Dermatol 2016; 34:654-7. [PMID: 27638447 DOI: 10.1016/j.clindermatol.2016.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Lately, the innovative concept of an immunocompromised cutaneous district (ICD) has been introduced to explain why a previously injured cutaneous site may become in time a privileged location for the onset of opportunistic infections, tumors, and immune reactions. The injuring events capable of rendering a skin region a potential ICD are various, numerous, and most of the time identifiable by means of a careful clinical history. The reason that only a small minority of injured skin areas actually becomes ICDs, with subsequent opportunistic localization of a second and unrelated skin disorder, is presently unknown. The ICD is a conceptual entity that is not limited to human dermatology. It can also apply to veterinary medicine. Development of sarcomas at the injection site in cats after routine vaccination and, occasionally, administration of pharmaceutical products, as well as insertion of any foreign body, is a repeatedly documented event. Antigen load, persistent inflammation, and fibroblastic proliferation are thought to be important factors predisposing to the onset of fibrosarcoma in cats. Recently, it has been hypothesized that a local immunosuppression caused by inhalant glucocorticoids may have favored the development of regional demodicosis in cats. In our opinion, injection-site sarcomas and feline localized demodicosis can be considered examples of veterinary ICDs.
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Affiliation(s)
- Stefano Caccavale
- Department of Dermatology, Second University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Eleonora Ruocco
- Department of Dermatology, Second University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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Caccavale S, Caccavale T, La Montagna M. Hidradenitis suppurativa associated with squamous cell carcinoma: an example of an isoscartopic response. Int J Dermatol 2016; 55:e629-e631. [DOI: 10.1111/ijd.13375] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/12/2016] [Accepted: 05/11/2016] [Indexed: 01/01/2023]
Affiliation(s)
- Stefano Caccavale
- Department of Dermatology; Second University of Naples; Naples Italy
| | - Tobia Caccavale
- Department of Dermatology; Second University of Naples; Naples Italy
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Caccavale S, Caccavale T, La Montagna M. Facial flat warts in a young patient with a previous trauma: an example of isotraumatopic response. Int J Dermatol 2016; 55:e568-9. [PMID: 27260535 DOI: 10.1111/ijd.13328] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/08/2016] [Indexed: 11/29/2022]
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Chiriac A, Podoleanu C, Moldovan C, Stolnicu S. Notalgia Paresthetica, A Clinical Series and Review. Pain Pract 2016; 16:E90-1. [DOI: 10.1111/papr.12436] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/02/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Anca Chiriac
- Department of Dermato-Physiology; Apollonia University; Iasi Romania
- Department of Dermatology; Nicolina Medical Center; Iasi Romania
- ”P. Poni” Research Institute of Macromolecular Chemistry; Romanian Academy of Science; Iasi Romania
| | - Cristian Podoleanu
- Department of Cardiology; University of Medicine Targu Mures; Targu Mures Romania
| | - Cosmin Moldovan
- Department of Histology; University of Medicine Targu Mures; Targu Mures Romania
| | - Simona Stolnicu
- Department of Pathology; University of Medicine Targu Mures; Targu Mures Romania
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Caccavale S, Caccavale T, La Montagna M. Varicella within a Prior Immunization Reaction Site: Another Example of "Isovaccinetopic Response". Pediatr Dermatol 2016; 33:357-8. [PMID: 27176809 DOI: 10.1111/pde.12846] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stefano Caccavale
- Department of Dermatology, Second University of Naples, Naples, Italy
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Caccavale S, Squillace L, Ruocco E. Tattoo-induced psoriasis: an umpteenth example of immunocompromised district. Int J Dermatol 2016; 55:e511-2. [PMID: 27125903 DOI: 10.1111/ijd.13251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/10/2015] [Accepted: 11/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Stefano Caccavale
- Department of Dermatology, Second University of Naples, Naples, Italy.
| | - Lorenzo Squillace
- Department of Dermatology, Second University of Naples, Naples, Italy
| | - Eleonora Ruocco
- Department of Dermatology, Second University of Naples, Naples, Italy
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Caccavale S, La Montagna M, Caccavale T. Isoscartopic Response: Another Facet of the Immunocompromised Cutaneous District. Indian J Dermatol 2016; 61:219-20. [PMID: 27057029 PMCID: PMC4817454 DOI: 10.4103/0019-5154.177770] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Stefano Caccavale
- Department of Dermatology, Second University of Naples, Naples, Italy. E-mail:
| | | | - Tobia Caccavale
- Department of Cardiovascular Surgery and Transplant, Second University of Naples, Naples, Italy
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Abstract
Chronic itch in the elderly is a common problem, with a significant impact on quality of life and sleep in elderly patients. Chronic itch may be attributable to several causes, including dry skin, immunosenescence and neural degeneration. Itch may also be caused by skin diseases, such as seborrhoeic dermatitis and stasis dermatitis; systemic conditions, such as end-stage renal disease and diabetes; and psychogenic conditions, such as depression and anxiety. The use of polypharmacy may also cause itch, with or without a rash. Specifically, thiazides and calcium channel blockers have been known to cause itch in elderly patients. Management should be tailored according to the underlying dermatological or systemic aetiology of itch. Topical treatment is the mainstay of therapy, providing special emphasis on skin hydration and barrier repair. In addition, topical and oral medications that target the nervous system and reduce neuronal hypersensitization, such as gabapentin and selective antidepressants, have a role in treating patients with severe chronic itch. Furthermore, management must account for changes in metabolism and pharmacokinetics of drugs in the aging population in order to prevent the occurrence of adverse effects.
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Caccavale S, Caccavale T, La Montagna M. Post Herpes Zoster Trigeminal Trophic Syndrome in a Child: An Example of Immunocompromised District. Indian J Dermatol 2016; 61:124. [PMID: 26955150 PMCID: PMC4763664 DOI: 10.4103/0019-5154.174162] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stefano Caccavale
- Department of Dermatology, Second University of Naples, Naples, Italy. E-mail:
| | - Tobia Caccavale
- Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy
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Caccavale S, Kannangara AP, Ruocco E. Categorization of and comments on isomorphic and isotopic skin reactions. Clin Dermatol 2015; 35:105-110. [PMID: 27938807 DOI: 10.1016/j.clindermatol.2015.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Locus minoris resistentiae (lmr) can be defined as a site of the body that offers lesser resistance than the rest of the body to the onset of disease. The well-known Köbner phenomenon is itself a clear example of lmr in dermatology. The new term locus maioris resistentiae (LMR), a site of the body that offers greater resistance than the rest of the body to the onset of disease, defines the opposite condition. Renbök phenomenon (reverse Köbner's isomorphic response) typically represents an example of LMR.
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Affiliation(s)
- Stefano Caccavale
- Department of Dermatology, Second University of Naples, Naples, Italy.
| | | | - Eleonora Ruocco
- Department of Dermatology, Second University of Naples, Naples, Italy
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Caccavale S, La Montagna M. Uncommon superficial angiomyxoma of the vulva complicated with condyloma acuminatum andStaphylococcus hominisinfection: a mere example of gynecological immunocompromised district. Int J Dermatol 2015; 54:e505-6. [DOI: 10.1111/ijd.12931] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/09/2014] [Accepted: 12/03/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Stefano Caccavale
- Department of Dermatology; Second University of Naples; Naples Italy
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