Brachioradial itch: intensely itchy and burning arms

Brachioradial itch involves intense itching, burning or a changed sensation when touching the skin of the upper extremities, which is of a neurogenic nature. No clear skin abnormalities are visible. It often affects the upper arm, but the forearm can also be affected. It can occur unilaterally or bilaterally, that is, on one side of the body or on both sides. Scratching reportedly worsens the discomfort. Most patients discover at some point that the application of cold compresses can provide relief from the complaints. Brachioradial itch was first described in the United States by Waisman.ยน

  • What is brachioradial itch?
  • Causes of brachioradial itch
  • Symptoms: intensely itchy and burning arms
  • Examination and diagnosis
  • Blood tests
  • Thyroid, liver and kidney function
  • X-rays
  • Treatment of brachioradial itching
  • Sun protection
  • Anti-itch creams
  • Tablets against itching
  • Prognosis
  • Complications
  • Prevention

 

Brachioradial itching / Source: Syda Productions/Shutterstock.com

What is brachioradial itch?

Brachioradial pruritus (itching) is a condition characterized by deep, intense itching, burning or an altered sensation when touching the skin on the upper arms (sometimes the forearms). This condition is relatively rare in European countries. It owes its name to the fact that the complaints are specifically felt at the level of the brachioradial muscle on one or both upper arms. This muscle is located on the outside of the upper arm. External skin abnormalities are absent. The itching often manifests itself on one side, sometimes on both sides and symmetrically. To date, there is still much uncertainty about the cause.

Causes of brachioradial itch

Brachioradial itch is caused by constant irritation and damage to the nerves in the skin, and it is not clear what the precise mechanism is. In other words: the cause is not (yet) known. A connection is made with damage to the nerve as a result of neck injury, either due to trauma or inflammation. Sunlight may also play a role. The condition is more common in sunny climates than in temperate climates, and is mainly seen in people with fair skin types (Australia, South Africa).

Symptoms: intensely itchy and burning arms

Typical symptoms of this condition are a severe, disturbing, deep, burning and itchy sensation in the skin of the upper arms (sometimes forearms). Frequent scratching to reduce itching can lead to scratching effects (small wounds and bruises). This damage can lead to dark pigmented spots, hypopigmentations and even scars.

Examination and diagnosis

Identifying the cause of your itching may take some time and a physical examination and careful review of your medical history is important in making the diagnosis. If the doctor suspects that your itchy skin is the result of an underlying medical condition, he or she may perform tests including:

Blood tests

A complete blood count may indicate an internal condition causing itching, such as iron deficiency.

Thyroid, liver and kidney function

Liver or kidney disease and thyroid abnormalities, such as hyperthyroidism (overactive thyroid), can cause itching. Therefore, the doctor may perform a thyroid function test, a liver function test or a kidney function test.

X-rays

Signs of underlying disease associated with itchy skin, such as enlarged lymph nodes, can be seen through the use of X-rays.

Treatment of brachioradial itching

Sun protection

Brachioradial pruritus is a chronic problem that can be very persistent and difficult to control. Protecting the skin against sunlight often provides some relief. You can do this with clothing or sunblockers with a high protection factor.

Anti-itch creams

Itching can be combated with anti-itch creams such as menthol cream or gel or capsaicin cream. This cream actually stimulates the skin nerves, resulting in nerve exhaustion, which means that itching signals can no longer be transmitted properly. This product should be applied several times a day. It is only available with a doctor’s prescription. In rare cases, side effects may occur when using Capsaicin. Burning and irritation (redness of the skin) are especially seen. In high doses it can even cause blisters, inflammation and pain.

Medication for brachioradial itching / Source: Stevepb, Pixabay

Tablets against itching

Itch-relieving tablets can also be used. This may include hydroxyzine (Atarax) or polaramine. These tablets may make you a bit sleepy, so it is wise to only take them in the evening before going to sleep. Most patients discover at some point that the application of cold compresses can also provide (some) relief from the complaints.

Prognosis

Most people with brachioradial pruritus have remissions (periods when the symptoms disappear into the background), but in a small percentage the itching is chronic. Emotional or psychiatric factors probably play a role in the prognosis.

Complications

Mental symptoms, such as anxiety and depression, can develop over time in patients with unrelenting symptoms. The intense tingling, pricking, burning sensations and itching can keep you awake at night, causing insomnia and sleep deprivation. Frustration due to lack of relief of symptoms with conventional (regular) anti-itch medications is common.

Sunscreen / Source: Asiandelight/Shutterstock.com

Prevention

Good protection against the sun with sunscreen and clothing with long sleeves and trousers reduces the risk of brachioradial itching.
Note:

  1. Waisman M. Solar pruritus of the elbows (brachioradial summer pruritus). Arch Dermatol. Nov 1968;98(5):481-5.

 

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