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Brachioradial pruritus
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Brachioradial pruritus

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Contributors: Zachary W. Eyre BS, Douglas L. Powell MD, Jason E. Hawkes MD, Amanda Truong BS, Bethany K. H. Lewis MD, MPH, Jamie L. Woodcock MD
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Synopsis

Brachioradial pruritus (BRP) is a rare dermatosis characterized by recurrent itching of the dorsolateral arm with few primary skin findings.

BRP is seen in both men and women, most commonly in the 4th-6th decades of life, and familial cases have been described. BRP is most frequently seen in tropical areas. Although BRP has been described in patients of all skin types, patients with light skin phototypes (Fitzpatrick skin types I-III) are more frequently affected.

The exact pathophysiology of BRP is still unknown; however, two mechanisms have been proposed. The first hypothesis is that solar-induced nerve damage, most likely induced by ultraviolet radiation, damages superficial cutaneous nerve endings, causing pruritus. The other hypothesis suggests that cervical spine nerve damage or disease may be the etiology of BRP. A combination of the two mechanisms is likely, with cervical spine nerve compression predisposing patients to pruritus from solar-induced nerve damage.

Codes

ICD10CM:
L29.8 – Other pruritus

SNOMEDCT:
402178001 – Brachioradial pruritus

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Zoster sin herpete – Unusual presentation of herpes zoster where dermatomal pain is present without cutaneous rash. Usually presents with unilateral pain, with BRP often presenting bilaterally.
  • Notalgia paresthetica – Usually presents with a well-circumscribed, hyperpigmented patch on the back that may be pruritic and/or painful.
  • Neurotic excoriations – Itching and markings of excoriations are typically found in accessible areas, and are usually present on multiple areas of the body.
  • Xerosis (dry skin) – Typically presents with fine scale and accentuated skin markings.
  • Lichen simplex chronicus – One or more well-demarcated, lichenified plaques with exaggerated skin lines are found on any location that the patient can reach.
  • Prurigo nodularis – Usually presents with multiple discrete, scaly nodules or papules on the extensor surface of the arms and legs.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 09/13/2017
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Brachioradial pruritus
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Brachioradial pruritus : Bilateral, Burning skin sensation, Pruritus, Upper arms, Forearms
Clinical image of Brachioradial pruritus
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