Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
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We report on a female patient with brachioradial pruritus, in whom the cause could be verified by purposeful diagnostics (e. g., MRI). The clinical symptoms with localized itching result from circumscribed nerve root compression and hyperexcitation of the nerve fibers. Under treatment with gabapentin, an anticonvulsant with a very good analgesic and good antipruritic effect, the itch ceased and the skin changes healed. This case shows that this special form of neuropathic itch requires targeted therapy, which apart from symptomatic treatment should primarily focus on remedying the cause, if feasible.
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A 37 year old woman presented with a 4-month history of "plaques opalines" of the oral mucosa complaining of a rough feeling in her mouth and burning when swallowing. On the basis of clinical, histological and serological details and especially the presence of generalized indolent lymphadenopathy, the diagnosis of secondary syphilis was made. Although plaques opalines are a relatively rare manifestation of secondary syphilis, they can occasionally be the only sign and are important in the differential diagnostic considerations of gray-white mucosal lesions, especially with current continuing rise of syphilis incidence in Central Europe.