biology

Notalgia paresthetica

Notalgia paresthetica is a biology topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Notalgia paresthetica rather than just read about it. In short: Notalgia paresthetica or notalgia paraesthetica (NP) (also known as "hereditary localized pruritus", "posterior pigmented pruritic patch", and "subscapular pruritus") is a chronic sensory neuropathy. Notalgia paresthetica is a common localized itch, affecting mainly the area between the shoulder blades (especially the T2–T6 dermatomes) but occasionally with a more widespread distribution, involving the shoulders, ba…

Key takeaways

Notalgia paresthetica belongs to biology; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Notalgia paresthetica to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Notalgia paresthetica from memory before moving on to harder problems.

Reference excerpt

Notalgia paresthetica or notalgia paraesthetica (NP) (also known as "hereditary localized pruritus", "posterior pigmented pruritic patch", and "subscapular pruritus") is a chronic sensory neuropathy. Notalgia paresthetica is a common localized itch, affecting mainly the area between the shoulder blades (especially the T2–T6 dermatomes) but occasionally with a more widespread distribution, involving the shoulders, back, and upper chest. The characteristic symptom is pruritus (itch or sensation that makes a person want to scratch) on the back, usually on the left hand side below the shoulder blade (mid to upper back). It is occasionally accompanied by pain, paresthesia (pins and needles), or hyperesthesia (unusual or pathologically increased sensitivity of the skin to sensory stimuli, such as pain, heat, cold, or touch), which results in a well circumscribed hyperpigmentation of a skin patch in the affected area.

Causes The causes of this condition have not yet been completely defined. Patients are usually older persons. The correlation of notalgia paresthetica localization with corresponding degenerative changes in the spine suggests that spinal nerve impingement may be a contributing cause. According to Plete and Massey, "The posterior rami of spinal nerves arising in T2 through T6 are unique in that they pursue a right-angle course through the multifidus spinae muscle, and this particular circumstance may predispose them to harm from otherwise innocuous insults of a varied nature." Patients may have other conditions that predispose them to peripheral neuropathies (nerve damage).

Diagnosis Possible differential diagnoses are:

Allergic contact dermatitis Arthropod bite reaction Atopic Dermatitis Brachioradial pruritus Delusions of Parasitosis Drug eruptions Herpes Zoster Impetigo Irritant contact dermatitis Lichen simplex chronicus Neurodermatitis Postinflammatory hyperpigmentation Prurigo nodularis Pruritus and systemic disease Tinea corporis Tinea Versicolor Xerosis

Treatment Therapy for notalgia paresthetica is directed at controlling symptoms, as no cure exists for the condition. Available treatments include local anesthetics, topical capsaicin, topical corticosteroids, hydroxyzine, oxcarbazepine, palmitoylethanolamide and gabapentin. Paravertebral nerve block and botulinum toxin injections may also be helpful. Some patients treated with low concentration topical capsaicin reported pain, burning, or tingling sensations with treatment, and symptoms returned within a month of ceasing treatment. Oxcarbazepine was reported to reduce the severity of symptoms in a few cases. One patient has been treated with "paravertebral nerve blocks, with bupivacaine and methylprednisolone acetate injected into the T3–T4 and T5–T6 intervertebral spaces" Hydroxyzine has also been used with considerable success in some cases as long as the pills are used daily. High concentration topical capsaicin (8%, Qutenza) have been shown to be highly effective in treating neuropathic itch in some patients (including notalgia paresthetica) as well as in a recent proof-of-concept study. Most recently intradermal injections of botulinum toxin type A (Botox) have been tried with some success. Even though botulinum normally wears off in three to six months, the treatment appears to be long term, and it has been theorised that botulinum type A effects lasting change in pain signaling.

See also List of cutaneous conditions Hereditary neuralgic amyotrophy

References

Pleet, A Bernard and Massey, E Wayne, Notalgia Paresthetica, Neurology, Dec 1978; 28: 1310 Pleet, A Bernard and Massey, E Wayne, Letter to the Editor: Notalgia Paresthetica, Neurology, Vol. 29, Issue 4, 528 April 1, 1979

External links

Illustrations

Worked examples

Example 1 — a first encounter with Notalgia paresthetica

Start with the simplest possible case. Write down what Notalgia paresthetica claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In biology, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Notalgia paresthetica before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Notalgia paresthetica ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Notalgia paresthetica

In research: Notalgia paresthetica appears in biology research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Notalgia paresthetica in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Notalgia paresthetica is common in secondary-school and first-year university syllabi. It links to neighbouring topics Human back, Neurocutaneous conditions, Neurological disorders, so understanding it makes those chapters shorter.
In everyday life: Look for Notalgia paresthetica outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

Ask Teacher Smith questions about this articleOpens your AI tutor with a question about “Notalgia paresthetica” →

Affiliate

Preply — study more efficiently by working with a personal tutor. 50% off.

How to study Notalgia paresthetica in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Notalgia paresthetica means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Notalgia paresthetica out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Notalgia paresthetica in simple terms?

Why does Notalgia paresthetica matter?

Because it connects several biology ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Notalgia paresthetica?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Notalgia paresthetica.