A 50 year old man complains of a constantly itchy right outer arm. Exam shows only excoriations.

BRACHIORADIAL PRURITUS

Brachioradial pruritus (BRP), also known as solar pruritus of the elbows, is a term used to describe itching along the photoexposed parts of the arm. It is most common during the fourth through sixth decades of life, with equal distribution between men and women.

• Most cases of BRP seem to be sun-induced but others may be related to a neuropathy (estimated in one study to be about 25%).
• The classic patient is a professional driver whose arm hangs out the window while driving, but any adult may be affected.
  
• Pruritus along the extensor forearm on one side is characteristic. Occasionally, both sides are affected. It is often worse in the summer with sunlight exposure.
• Long-sleeved shirts to shield the arm from the sun may completely clear the symptoms, e.g. in 6 weeks. Interestingly, broad spectrum sunscreens seem not to be as helpful.
  
• Application of anything cold relieves symptoms and this may be helpful in diagnosis, the so called "ice-pack sign".
  

RegionalDerm

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