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    The etiology of notalgia paresthetica: a descriptive study of 117 patients
    (Springer London Ltd, 2020) Şenel, Engin; Holt, Shaun; Sabancılar, Emine; Sabancılar, Zafer; Doğruer Şenel, Seher
    Background Notalgia paresthetica (NP) is a neuropathic itching condition unilaterally localized in the midscapular area. It is a common but an underdiagnosed disease, and only a few studies investigating NP etiology with a limited number of patients have been reported in the literature. Objective We aimed to evaluate the demographic, clinical, histopathological, neurological, and radiological findings of NP patients and investigate correlations between them and symptoms of NP to elucidate the etiology of NP. Methods One hundred and seventeen consecutive patients diagnosed with NP were included and assessed in a multidisciplinary and prospective manner. We recorded demographic and clinical data and obtained a skin biopsy from the pruritic or hyperpigmented region. Pruritus severity was assessed by visual analogue scale (VAS). All patients were evaluated neurologically with magnetic resonance imaging. Results The mean age of the patients was 47.08 +/- 12.28 years. The disease was more common in females (87.2%). Statistical analysis revealed that VAS scores were independent of the age, gender, and skin type of the patient. We found no significant difference in VAS scores between NP patients with or without comorbidities. Vertebral pathologies detected by MRI and amyloid deposition revealed in histopathology were not among the main factors affecting VAS scores. Study Limitation Since consecutive patients enrolled into the study, we could not include equal number of male and female patients. Conclusion We found no correlation between symptom severity and findings from neurological and histopathological evaluations. Further microneurological studies should be carried out to elucidate the etiology of NP.
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    Treatment of Notalgia Paresthetica with Bee Venom and Capsaicin: A pilot study with 20 patients
    (NLM (Medline), 2019) Şenel, Engin; Holt, Shaun; Demir, Emre
    Notalgia paresthetica (NP) is a common clinical disorder characterized by hyperpigmentation, pruritus, paresthesia, and/or pain, located on the back. There is no effective treatment for patients with NP. We investigated the efficacy of a product containing bee venom (0.04%) and capsaicin (0.025%) for treating NP. Twenty patients (10 men and 10 women) with NP were included in this open-label pilot study. A biopsy was performed for each patient to exclude other dermatologic diseases. The patients were asked to apply the product to the pruritic areas once daily for 2 weeks. No other product was used during the study. The Visual Analogue Scale (VAS) score was used to evaluate the efficacy of the product. VAS scores before and after treatment were statistically different (?p = 0.005). The pretreatment median of VAS score was 8 (7-10) (8.20 ± 1.03), while the median after treatment was 3 (1-7) (3.40 ± 1.71). The product containing bee venom and capsaicin is effective in treating ?NP. A double-blind and placebo-controlled study has been planned and initiated with a greater sample size.