Successful Treatment of Notalgia Paresthetica With Botulinum Toxin Type A | Neurology | JAMA Dermatology | JAMA Network
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The Cutting Edge
August 2007

Successful Treatment of Notalgia Paresthetica With Botulinum Toxin Type A

Author Affiliations


Arch Dermatol. 2007;143(8):980-982. doi:10.1001/archderm.143.8.980

Notalgia paresthetica is a chronic condition that, while not life threatening, produces symptoms that are incessant and onerous to many patients. To date, there has been no effective, long-lasting, noninvasive treatment for this condition, which decreases the patient's quality of life.

A 52-year-old white woman presented with a 2- to 4-year history of pruritus of her upper back, which she described as a 7 on a severity scale of 1 to 10. She reported scratching her back twice a day. She had tried moisturizers and topical corticosteroids with no improvement. She recalled that her father had had a similar itch on his back for years that induced him to repeatedly scratch his back on a doorpost. Her medical history was remarkable only for gastroesophageal reflux disease, which was responsive to ranitidine, and for rosacea, for which she used topical metronidazole. She had no drug allergies. On physical examination, there was a 4 × 4-cm hyperpigmented patch on her right mid to upper back. Her presentation was consistent with notalgia paresthetica.