logo

DermNet NZ


Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Brachioradial pruritus

Brachioradial pruritus is a condition where itch, burning, stinging, tingling and/or changed sensation arise in the areas of skin on either or both arms. The most commonly affected area is the mid-arm, but forearms and upper arms can also be affected.

The affected skin may appear entirely normal. Visible changes may arise from rubbing and scratching the affected area. These include purpura and ecchymoses (bruises), hyperpigmentation (brown marks), hypopigmentation (white marks), lichen simplex (a type of eczema), prurigo and scarring. There may be changed sensation when this is tested for with pinprick, cotton wool or heat and cold.

Brachioradial pruritus occasionally expands to involve the lower legs or generalises to other sites.

Cause of brachioradial pruritus

Brachioradial pruritus is due to compression or traction of C fibre nerves in the cervical spine. As it was originally more often reported in sunny climates than in cooler areas, long term sun exposure has also been blamed.

In many cases, brachioradial pruritus is clearly due to nerve damage or radiculopathy in the cervical spine (neck), when it may be due to:

Prolonged compression of spinal itch-transmitting neurones can activate central sensitisation processes, affecting the A fibres. These convey light touch and pinprick symptoms, and stimulation can result in sensitive or painful skin with exaggerated response to light touch or pinprick (hyperaesthesia, hyperalgesia).

When compressed nerves atrophy (shrink), C fibres in the skin can proliferate.

A localised neuropathic itch may also expand to involve other dermatomes.

Treatment of brachioradial pruritus

Treatment is not always successful. Effective measures include the following:

Related information

References:

On DermNet NZ:

Other websites:

Author: Dr Amanda Oakley, Department of Dermatology, Health Waikato

DermNet NZ does not provide an online consultation service.
If you have any concerns with your skin or its treatment, see a dermatologist for advice.