Case report and short review: Botulinum toxin injection for the treatment of Notalgia parasthetica

Abstract

Notalgia Paresthetica (NP) is seen as a well demarcated hyperpigmented patch on the back usually between T2 & T6, medial or inferior to the scapula. It is said to be a sensory neuropathy of the back and is characterised by itching, lichenification, hyperkeratosis or xerosis. A 48-year-old patient with Notalgia Parasthetica was injected with microbotox and remained symptom free for 8 months. There are very few reports of NP treated with onabotulinum toxin, but it is worth a study. Notalgia Paresthetica (NP) is seen as a well demarcated hyperpigmented patch on the back usually between T2 & T6, medial or inferior to the scapula (1). It is often unilateral and is said to be a sensory neuropathy of the back. Some patches exhibit lichenification, hyperkeratosis or xerosis (2-4). Patients often complain of intense pruritis. Other symptoms are pain, parashthesia, burning sensation, hypoaesthesia, hyperaesthesia. NP can have a negative effect on the patient’s quality of life. Various modalities of treatment in the form of topical and oral medications have been tried and are at their best temporary. There have been 4 reports of botulinum toxin injected in patients with NP. The author injected botulinum toxin in her patient who complained of relentless itching and found improvement in her symptoms.