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A Systematic Review of Procedural Modalities in the Treatment of Notalgia Paresthetica Publisher Pubmed



Nilforoushzadeh MA1, 2 ; Ghane Y1, 2, 3 ; Heidari N1, 2, 4 ; Azizi H1, 2 ; Fathabadi F1, 2, 3 ; Najar Nobari N1, 2 ; Heidari A1, 2, 5
Authors
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Authors Affiliations
  1. 1. Skin Repair Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

Source: Skin Research and Technology Published:2024


Abstract

Background: Notalgia paresthetica (NP) is a rare condition characterized by localized pain and pruritus of the upper back, associated with a distinct area of hyperpigmentation. Given the lack of standardized treatment and the uncertain efficacy of available options, applying procedural methods is of growing interest in treating NP. Aims: We sought to comprehensively evaluate the role of procedural treatments for NP. Methods: We systematically searched PubMed/Medline, Ovid Embase, and Web of Science until November 14th, 2023. We also performed a citation search to detect all relevant studies. Original clinical studies published in the English language were included. Results: Out of 243 articles, sixteen studies have reported various procedural modalities, with or without pharmacological components, in treating NP. Pharmacological procedures, including injections of botulinum toxin, lidocaine, and corticosteroids, led to a level of improvement in case reports and case series. However, botulinum toxin did not show acceptable results in a clinical trial. Moreover, non-pharmacological procedures were as follows: physical therapy, exercise therapy, kinesiotherapy, acupuncture and dry needling, electrical muscle stimulation, surgical decompression, and phototherapy. These treatments result in significant symptom control in refractory cases. Physical therapy can be considered a first-line choice or an alternative in refractory cases. Conclusion: Procedural modalities are critical in the multidisciplinary approach to NP, especially for patients who are refractory to topical and oral treatments. Procedural modalities include a spectrum of options that can be applied based on the disease's symptoms and severity. © 2024 The Authors. Skin Research and Technology published by John Wiley & Sons Ltd.