Wlotzke U, Stolz W, Hohenleutner U, Dorfmüller P, Korting H C, Landthaler M
Dermatologische Klinik, Universität Regensburg.
Dtsch Med Wochenschr. 1994 Sep 30;119(39):1307-11. doi: 10.1055/s-2008-1058837.
For 3 years a 75-year-old man with type II diabetes had been suffering from paroxysmal pruritus in a circumscribed area of brown discoloration of the skin over the left should blade. This condition, also known as notalgia paraesthetica, is a rare, but perhaps underdiagnosed, neurocutaneous entity, a largely sensory neuropathy due to a muscular compression phenomenon. In this case histological examination of a biopsy specimen showed focal acanthosis, obvious basal hyperpigmentation and discrete perivascular lymphocytic infiltration with numerous melanophages. At first, glucocorticoids were administered unsuccessfully against the distressing pruritus. Purely symptomatic local capsaicin treatment decreased the pruritus temporarily. Endocrinological diagnosis failed to demonstrate multiple endocrine neoplasia (MEN) syndrome 2A, which has been frequently described in association with notalgia paraesthetica.
三年来，一名75岁的II型糖尿病男性患者，其左肩胛皮肤褐色色素沉着的局限区域一直遭受阵发性瘙痒。这种情况，也被称为感觉异常性背痛，是一种罕见的、但可能未被充分诊断的神经皮肤疾病，主要是由于肌肉压迫现象导致的感觉神经病变。在这个病例中，活检标本的组织学检查显示局灶性棘皮症、明显的基底色素沉着以及离散的血管周围淋巴细胞浸润，并伴有大量噬黑素细胞。起初，使用糖皮质激素治疗令人痛苦的瘙痒未取得成功。单纯的对症局部辣椒素治疗暂时减轻了瘙痒。内分泌诊断未能证实与感觉异常性背痛经常相关的2A型多发性内分泌肿瘤（MEN）综合征。
