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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 8474
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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I have constant itching on my left arm only between my elbow

Resolved Question:

I have constant itching on my left arm only between my elbow and wrist.   top of the arm. It wont stop itching and i am miserable. I cant sleep and my dermatologist said it was brachialradialus syndrom.   He would not prescribe anything for the itching. I have tried benabryl ointment, cortisone ointment and oral pills and it wont stop the itching HELP. Do i need to see a Neurologist asap
This has been going on for weeks now and i need help and sleep
Submitted: 4 years ago.
Category: Dermatology
Expert:  Dr. Nair replied 4 years ago.
Hi,

Yes your symptoms sound consistent with Brachioradial pruritis. Do you have any cervical spine disease - like neck pain, spondylosis etc? Any other joint problems like rheumatoid arthritis?

Does the itching become worse on exposure to the sun? How long have you had these symptoms - do they improve in winter?
Customer: replied 4 years ago.

I do not have neck pain. I did have neck surgery 3 years ago for an accident where i had a spur that punctured my spinal cord. The neuro surg shaved off the spur and found 2 bulging discs in my neck but decided to leave it alone. I have been left with numbness in my right thumb, but have never experienced or had problems with this itching on the left arm only. The itching started coming and going just in the past few weeks. I feel it is getting worse and i need relief.

I work outside. but i cant really tell you that sun makes it worse. The itching is pretty much all the time now. It does seem that as the days get dryer coming into the fall that i am itching more. I have tried to use moisturizing lotions and limit my showering to just enough time to soap up good in warm water and then get out. I stopped taking real hot showers. I am using a moisturizing bath soap too.

Expert:  Dr. Nair replied 4 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

Thank you for the information. Cervical injury and bulging intervertebral discs are a well documented cause of brachioradial pruritis especially if occurring at the C5-C6 level. Other causes postulated include excessive sun exposure.

Many cases benefit from acupuncture. Correction of any cervical spine abnormality generally leads to a prompt resolution of symptoms and for this you would have to schedule a consult with both a neurologist & if required a neurosurgeon.

Brachioradial pruritis otherwise can be quite difficult to treat but the following should help:

1. Capsaicin cream: applied 3-4 times a day over the affected area. Takes 4-6 weeks to start working

2. Tab Doxepin 25 mg once at night.

3. Cool compresses(with wrapped, crushed ice) to the affected part when the itching is unbearable.

4. Tab Gabapentin 300 mg once a day for 7 days, then dose increased by 300 mg every 4th day (i.e 300 twice a day, then 300 morning, 600 night, then 600 twice a day etc) - till the itching subsides or a maximum dose of 2400.g/day is reached or the dose cannot be increased any more because of excessive sedation.

Please note: When the dose of gabapentin exceeds 600mg/day, stop the doxepin.

5% Lidocaine gel & Doxepin gel applied over the affected area has also shown benefit in some patients. These can be tried if the capsaicin does not help. Please note that all of the above will require a prescription. Hope this helps!
Expert:  Dr. Nair replied 4 years ago.
Hi,

Did you receive my answer to your question sent yesterday?
Customer: replied 4 years ago.
I did receive your answer. Thank you. I went to my GP yesterday and he said he felt it was not Brachioradial pruritis. He gave me Betamethasone Cream and Hydroxyzine HCL 25 mg for the itching. With in 2 hours the itching had stopped. I found instant relief. I am going to just document my symptoms and watch it for awhile. I thank you for your information and will keep this handy as well as send a copy to my GP for further reference. I am paying you for your time. I appreciate all that you have sent me. Thank you, Again.
Expert:  Dr. Nair replied 4 years ago.
Hi again,

I am very glad you have found such instant relief. Brachioradial pruritis does not usually benefit from antihistamines like hydroxyzine and benadryl - so yes it may be too early to label it as brachioradial pruritis yet. Kindly press the ACCEPT button if you'd like to pay me as JustAnswer only pays the experts once this is done. The payment will be made from the deposit you have already made - there will be no extra charge. And please feel free to get back to at any time regarding your condition. All the best!
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 8474
Experience: MBBS, MD (Dermatology, Venereology & Leprology)
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