臂桡侧瘙痒症1例及文献复习

Case Report of Brachioradial Pruritus and Literature Review

目的报道1例臂桡侧瘙痒症,并回顾文献,学习该病的临床特征、影像学变化及治疗,以提高临床医生对该病的认识。方法分析1例臂桡侧瘙痒症患者的临床表现、影像学检查及治疗预后,并复习近年国内外相关文献。结果老年男性患者,近1年无明显诱因出现双侧前臂瘙痒,夜间较重,不能忍受。皮肤科情况:双前臂外侧散在暗红色粟粒大小坚实丘疹,大片褐色色素沉着。患者既往颈椎病多年,颈椎X光片示颈椎退变,C5-C6椎间隙狭窄。颈部核磁共振成像(MRI)示C3-C7多节段椎间盘突出,椎管狭窄,以C5-C6为著。诊断:臂桡侧瘙痒症。治疗:0.1%他克莫司软膏(商品名:普特彼软膏)2次/d外用。2周后瘙痒明显减轻,1个月后皮疹消失,无瘙痒感,停药,3个月随访暂无复发。结论臂桡侧瘙痒症发病可能与颈椎退变相关,治疗可选择外用他克莫司软膏。

Objective In order to report a case of brachioradial pruritus and review the clinical manifestation and treatment ofbrachioradial pruritus. Methods The clinical, radiographic features, therapy and prognosis were summarized. Literaturesabout brachioradial pruritus were reviewed. Results A 74-year old male with a history of cervical spondylosis felt severeitching over bilateral forearms. Physical examination revealed localized erythematous papular and chromatosis over theforearms. Radiograph and magnetic resonance imaging revealed cervical degeneration and cervical disc herniation at C5-6segment. The diagnosis was brachioradial pruritus and the patient was treated with topical 0.1% tacrolimus ointment twicedaily over the affected area. The pruritus was relieved at 2-week follow-up and the patient was cured at 4-week follow-up. Norecurrence was detected at 3-month follow-up. Concludion Brachioradial pruritus might be relevant to cervical spondylosis.Tacrolimus ointment can be used to treat brachioradial pruritus.