BRACHIORADIAL PRURITUS
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I recently saw a pysch nurse with reiter's syndrome who complained of
'burning pain and itching' of the upper outer arms with no history of 
neck problems, and no skin findings other than excoriations.  i tried 
zostrix and zyrtec without help; she called almost every day to say she 
couldn't sleep from the discomfort, so i suggested she get her 
rheumatologist to rx elavil (i don't feel comfortable with the big league 
supratentorial drugs)...one day later, at a 10mg dose, she's all 
clear...the 'burning' sensation is what suggested to me that she has some 
sort of neurological involvement ?secondary to reiters?...steve

Steven D. Emmet, M.D.  
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Consider Brachioradal Pruritus, where patients describe a sensation of 
deep pruritus and burning sensation especially of the extensorsides of 
the arms and especially the forearms.  Characteristically scratching 
doesn't help, the sensation is apparently too deep in the skin. Normally 
no physical signs are observed. The cause is unknown, but is believed to 
be a passing neuropathia due to intense sun light. Normally it will 
subside spontaneously within a month.

Mads Nielsen, MD
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I have several pts with what I call brachio-radial pruritus - but I don't 
seem to have the good fortune to see them get better in  a couple of 
months.  They have frequent and persistent sx, often at night. Trials of 
Pramagel,  Zonalon, menthol, topical steroids, all relatively unhelpful.

Jerry Eisner
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On Kauai we see brachioradial pruritus frequently, especially in the
summer months. I have  seen spontateous remissions, but usually not 
before the patient is miserable and sleepless. In desperation I sent a 
patient with chronic, recurring disease to an acupuncturist. He reported
sigificant relief after several visits. I wondered if treatment just
corresponded with a natural remission and hesitated to make much of it. 
At the recent PDA meeting, George Martin, dermotologist from Maui, 
reported that his office nurse found significant improvement after one 
visit to an acupuncturist. Since then I have had a woman remain 
relatively symptom free with a treatment every other week. Expensive, but 
she seems happy to pay it. Hope this is of some help.

Sally Moore PA-C
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On Maui, we see lots of brachioradial pruritus. I am still not convinced
this is solar activated, but I usually find that Ice compresses, potent
steroid topically and attempts at sun avoidance is helpful. I, too, will
try accupuncture for my recalcitrant patients. Sleeves to cover the arms
during driving, golf, tennis, etc. are the best protection for the arms.

Gary Salenger
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I thought topical capsaicin was the treatment of choice for this
disorder......Do you Hawaii dermatologists not find it useful????

Mark Valentine
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It takes too long to work and it burns.

gary salenger
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