Cutis
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Case Reports
Notalgia paresthetica associated with cervical spinal stenosis and cervicothoracic disk disease at C4 through C7.
Notalgia paresthetica (NP) is a common refractory, sensory, neuropathic syndrome with the hallmark symptom of localized pruritus of the unilateral infrascapular back. It generally is a chronic noncurable condition with periodic remissions and exacerbations. While the dermatologic syndrome may be multifactorial in etiology, a possible association with underlying cervical spine disease should be evaluated for proper treatment. ⋯ First-line therapy for NP with associated cervical disease may include nondermatologic noninvasive treatments such as spinal manipulation, physical therapy, massage, cervical traction, cervical muscle strengthening, and oral nonsteroidal anti-inflammatory drugs and muscle relaxants. Notalgia paresthetica may in fact be a cutaneous sign of an underlying degenerative cervical spine disease. We report a case of a patient with cervical spinal stenosis that corresponded directly with the clinical findings of NP.
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The US military in conjunction with allied military services and nongovernmental organizations have embarked on various humanitarian missions to underserved areas worldwide. These missions illustrate what interoperability between nations can accomplish. Dermatologists involved with humanitarian missions encounter many conditions rarely seen in developed countries and learn to practice general dermatology with limited resources in austere environments.