Treatment of Brachioradial Pruritus: A Systematic Review

Abstract

AbstractImportance: Brachioradial pruritus (BRP) is a poorly understood disease and can severely impact quality of life. However, there is currently no clear treatment.\xa0Objective: To identify effective behavioral, topical, oral, and invasive treatment options for BRP, and to discuss the quality of the data currently found in the literature.\xa0Evidence Review: The PubMed and CINAHL databases were systematically reviewed for articles from 1968 to the present containing search terms “brachioradial OR solar OR forearm AND pruritus OR itching.” Results were narrowed to articles written in English, focusing specifically on BRP, and that stated precise treatment modalities. Evidence quality was determined based on the study type.\xa0\xa0Findings: Thirty-six articles discussing treatments for BRP are included in this review with a total 399 patients.\xa0 Six studies (n=68) report on the efficacy of capsaicin cream, eight studies (n=26) on oral gabapentin 300 mg daily to six times daily and four studies (n=98) on sun protection. The remaining articles comprise of low-quality, small-scale studies on further oral medications, physical therapy, minimally-invasive procedures, and surgery.\xa0Conclusions and Relevance: Low-quality evidence supports the use of sun protection, topical capsaicin, or oral gabapentin as effective therapeutic modalities for BRP. Clinicians should be aware of possible underlying cervical spine pathology and include thorough imaging as part of BRP work-up. Further high-quality studies on BRP treatments would help elucidate clear management for this disorder.