Notalgia parestesica. Descrizione di un caso con studio immunoistochimico dell'innervazione cutanea.

A case of notalgia paresthesica in a 62-year-old woman is reported. The patient complained of a intense itching, and occasionally burning, brown macule of six years duration on the back. Histologic examination showed increased melanin deposition in the basal layer of epidermis, numerous dermal melanophages, and scattered necrotic keratinocytes in both the epidermis and stratum corneum.Immunohistochemistry on frozen section revealed normal number and distribution of nerve fibers reactive for the general neural markers PGP 9.5 and neuron- specific enolase, and for the neuropeptides substance P-, vasoactive intestinal peptide-,and neuropeptide Y. Topical treatment with capsaicin improved pruritus and paresthetic sensations.