Brachioradial Pruritus

Brachioradial pruritus (BRP) is a localized neuropathic dysesthesia involving the dorsolateral upper extremities (see . Brachioradial Pruritus). The condition primarily affects middle-aged White women and demonstrates a seasonal pattern, with exacerbation during warmer months. Cervical radiculopathy or upper extremity neuropathy, often precipitated by UV radiation (UVR) exposure, is considered the principal pathogenic mechanism. BRP was first described in Florida in 1968 by Waisman and has since been reported in other subtropical regions, including South Africa and Hawaii. The number of documented cases and current investigations remains limited, owing to the condition's benign and often transient course. Dermatologic identification of BRP through focused history and examination is generally straightforward despite the broad differential for pruritic disorders. Ancillary investigations such as imaging, laboratory testing, or subspecialty referral are seldom required. Management of BRP remains challenging. Application of ice packs provides immediate yet temporary relief, whereas outpatient interventions such as spinal manipulation, physical therapy, or acupuncture may offer variable benefit. Pharmacologic therapies, including topical agents, gabapentinoids, and tricyclic antidepressants, have shown inconsistent efficacy. Surgical intervention is rarely indicated but may be considered in refractory cases.