Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Skin Res Technol. 2024 May;30(5):e13723. doi: 10.1111/srt.13723.
Notalgia paresthetica (NP) is a rare condition characterized by localized pain and pruritus of the upper back, associated with a distinct area of hyperpigmentation. Given the lack of standardized treatment and the uncertain efficacy of available options, applying procedural methods is of growing interest in treating NP.
We sought to comprehensively evaluate the role of procedural treatments for NP.
We systematically searched PubMed/Medline, Ovid Embase, and Web of Science until November 14th, 2023. We also performed a citation search to detect all relevant studies. Original clinical studies published in the English language were included.
Out of 243 articles, sixteen studies have reported various procedural modalities, with or without pharmacological components, in treating NP. Pharmacological procedures, including injections of botulinum toxin, lidocaine, and corticosteroids, led to a level of improvement in case reports and case series. However, botulinum toxin did not show acceptable results in a clinical trial. Moreover, non-pharmacological procedures were as follows: physical therapy, exercise therapy, kinesiotherapy, acupuncture and dry needling, electrical muscle stimulation, surgical decompression, and phototherapy. These treatments result in significant symptom control in refractory cases. Physical therapy can be considered a first-line choice or an alternative in refractory cases.
Procedural modalities are critical in the multidisciplinary approach to NP, especially for patients who are refractory to topical and oral treatments. Procedural modalities include a spectrum of options that can be applied based on the disease's symptoms and severity.
感觉异常性背疼（NP）是一种罕见病症，其特征为上背部出现局部疼痛和瘙痒，并伴有明显的色素沉着区。鉴于缺乏标准化治疗方法，且现有治疗方案的疗效不确定，因此，程序性治疗方法在治疗 NP 方面的应用越来越受到关注。
我们旨在全面评估程序性治疗方法在 NP 中的作用。
我们系统地检索了 PubMed/Medline、Ovid Embase 和 Web of Science，检索时间截至 2023 年 11 月 14 日。我们还进行了引文搜索，以发现所有相关研究。纳入了以英文发表的原始临床研究。
在 243 篇文章中，有 16 项研究报告了各种程序性治疗方法，包括有或没有药物成分的治疗方法，用于治疗 NP。药物程序，包括注射肉毒毒素、利多卡因和皮质类固醇，在病例报告和病例系列中显示出一定程度的改善。然而，肉毒毒素在临床试验中并未显示出可接受的结果。此外，非药物程序如下：物理治疗、运动疗法、运动疗法、针灸和干针、电肌肉刺激、手术减压和光疗。这些治疗方法可显著控制难治性病例的症状。物理治疗可被视为难治性病例的一线选择或替代方案。
程序性治疗方法在 NP 的多学科治疗中至关重要，特别是对于对局部和口服治疗有抗药性的患者。程序性治疗方法包括一系列可根据疾病症状和严重程度选择的治疗方案。
