Berger Amnon A, Urits Ivan, Hasoon Jamal, Simopoulos Thomas
Department of Anesthesia, Critical Case and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America.
Case Rep Womens Health. 2020 Mar 30;26:e00197. doi: 10.1016/j.crwh.2020.e00197. eCollection 2020 Apr.
Chronic pruritus affects up to 20% of the population; about 8% of patients suffer from neurogenic pruritus, including notalgia paresthetica (NP). This is a syndrome of benign, chronic itch of the unilateral medial border of the scapula of unknown etiology and limited treatment efficacy. Here we report the background on NP, followed by a classic case presentation of a 63-year-old woman. We report on difficulty in her diagnosis and numerous failed lines of treatment, until initiation of treatment with duloxetine, which provided her with long-lasting benefit for the first time. Delay in diagnosis is common for NP, and though there are many options for treatment, evidence is lacking to support their efficacy. Finding an effective, well-tolerated regimen to alleviate long-term suffering brought on by this syndrome is heavily dependent on early identification. Our case provides anecdotal evidence for both treatment efficacy as well as the etiology of this poorly understood phenomenon.
慢性瘙痒影响着多达20%的人群；约8%的患者患有神经源性瘙痒，包括感觉异常性背痛（NP）。这是一种病因不明、治疗效果有限的良性慢性瘙痒综合征，表现为单侧肩胛内侧缘瘙痒。在此，我们报告NP的背景情况，随后呈现一位63岁女性的典型病例。我们报告了她诊断过程中的困难以及多次治疗失败的情况，直到开始使用度洛西汀治疗，才首次为她带来了持久的疗效。NP的诊断延迟很常见，虽然有多种治疗选择，但缺乏支持其疗效的证据。找到一种有效且耐受性良好的方案来缓解该综合征带来的长期痛苦，很大程度上依赖于早期识别。我们的病例为这种了解甚少的现象的治疗效果及病因提供了实例证据。
