Brief ReportsOpen pilot study on oxcarbazepine for the treatment of notalgia paresthetica☆
Section snippets
Case report
A 29-year-old woman presented to the dermatology clinic with a 2-year history of a pruritic hyperpigmented patch on her back (Fig 1). She also complained of episodic pain in that area. Various antihistamines, analgesics, and topical corticosteroids had not brought relief. The dermatologic diagnosis of NP was made, and the patient was started on a regimen of oxcarbazepine 300 mg twice daily. At the end of 1
Results
This response to oxcarbazepine in our patient led us to prescribe the same medication in 4 more patients with NP. One patient had to stop using oxcarbazepine because of headache and dizziness within the first 2 weeks of treatment. The remaining 3 patients were followed up for 6 months with monthly physical and laboratory examinations. No unwanted clinical or laboratory findings were observed in these patients during this period.
The therapeutic regimens and monthly scores of the symptoms of all
Discussion
Although NP has been generally accepted to be a sensory neuropathy, its pathogenesis has not been completely elucidated. Factors implicated include a hereditary component, increased dermal innervation, neurotoxicity of certain chemicals, and spinal nerve injury resulting from trauma or entrapment.4, 8, 9, 10, 11, 12 Just as the exact pathomechanisms of NP are not clear, there is also no well-established and curative mode of treatment for this disorder. Among the therapeutic alternatives
References (16)
- et al.
Notalgia paresthetica, case reports and histologic appraisal
J Am Acad Dermatol
(1988) Treatment of notalgia paresthetica with topical capsaicin
J Am Acad Dermatol
(1991)- et al.
Symptoms of notalgia paresthetica may be explained by increased dermal innervation
J Invest Dermatol
(1991) - et al.
Successful treatment of notalgia paresthetica with topical capsaicin: vehicle-controlled, double-blind, crossover study
J Am Acad Dermatol
(1995) - et al.
Notalgia paresthetica associated with nerve root impingement
J Am Acad Dermatol
(1997) Notalgia paresthetica
J Am Acad Dermatol
(1986)- et al.
Successful treatment of notalgia paresthetica with a paravertebral local anesthetic block
J Am Acad Dermatol
(1998) - et al.
Localized pruritus: notalgia paresthetica
Arch Dermatol
(1979)
Cited by (52)
Alleviation of notalgia paresthetica with duloxetine after several lines offailed treatment: A case report
2020, Case Reports in Women's HealthCitation Excerpt :More recent trials of transcutaneous electrical nerve stimulation (TENS) showed mixed results. Importantly, NP is a benign condition, but can take months to years to resolve [4–7,2]. A recent review of treatments attempted to create an algorithmic approach to the use of the above-mentioned substances to provide an escalating treatment plan for NP [8].
Diagnosis and Management of Neuropathic Itch
2018, Dermatologic ClinicsCitation Excerpt :Although not as widely used as the gabapentinoids, 2 additional anticonvulsants, oxcarbazepine and carbamazepine, have been used in the treatment of neuropathic pruritus. In a small number of patients, oxcarbazepine has demonstrated some success in the treatment of notalgia paresthetica60 and brachioradial pruritus.61 Carbamazepine has been used to treat neuropathic itch in multiple sclerosis,62 PHN, trigeminal trophic syndrome,63 and brachioradial pruritus.64
Neurocutaneous disease: Neurocutaneous dysesthesias
2016, Journal of the American Academy of DermatologyCitation Excerpt :Lidocaine 2.5% and prilocaine 2.5% (EMLA) cream used twice daily has been shown to be beneficial; however, symptom relief was not sustained with cessation of application,105 similar to capsaicin. Systemic medications that have been tried with limited success include gabapentin,106 oxycarbazepine,107 and amitriptyline.108 One of the few head to head trials comparing therapies was a nonrandomized, nonblinded study comparing topical capsaicin with oral gabapentin, which showed superior improvement with gabapentin.
Notalgia paresthetica: Pruritus as marker of neurological damage
2014, Neurologia ArgentinaNotalgia paresthetica: Treatment using intradermal botulinum toxin A
2014, Actas Dermo-SifiliograficasNotalgia Paresthetica Review: Update on Presentation, Pathophysiology, and Treatment
2023, Clinics and Practice
- ☆
Reprint requests: Ekin Şavk, Adnan Menderes University Faculty of Medicine, Department of Dermatology, Aydin, Turkey.