Brachioradial Pruritus

Brachioradial pruritus (sometimes abbreviated BRP) is an intense itching sensation of the arm usually between the wrist and elbow of either or both arms. The itch can be so intense that sufferers will scratch their own skin to a bleeding condition.

The condition is becoming increasingly common, presenting in patients who are usually fair skinned, affluent, and middle aged that indulge in golf, tennis, sailing, or other leisure outdoor activities in sunny climates.

The cause is not known, although there are a few lines of thought on what causes it. No cure has been found. Many different medications and types of topical creams have been experimented with, but none seem to make any difference. The only thing that seems to help most sufferers is the application of ice to the area until the itch is diminished.

Brachioradial pruritus is a neurogenic itch syndrome of the upper extremities. The pruritus experienced by patients with brachioradial pruritus is believed to be a variant of pain. Brachioradial Pruritus is described as intense, itching, burning, and prickling. It is typically localized to the skin on the dorsolateral forearm overlying the proximal head of the brachioradialis muscle, but involvement of the upper arms and shoulders is also common. It may be unilateral or bilateral. Scratching reportedly only makes the discomfort worse, and most patients discover that application of of ice packs or cold, wet towels are often the only therapy that provides symptomatic relief. In addition Lidocaine 5% gel or patches are often the therapy that provides symptomatic relief. The discomfort is typically worse at night and, for some patients, may interfere with falling asleep. The median duration of symptoms has been reported as 4.5 years, but patients have reported a continuation of symptoms from this condition for as long as 18 years. Despite the severity of symptoms, no associated erythema or skin eruption is seen. Evidence of excoriation or lichenification may be present in the affected areas.