Neuropathic Pruritus: An Underrecognized and Often Misdiagnosed and Difficult to Treat Medical Condition

Neuropathic pruritus (NP), a type of chronic itching, accounts for about 8% of chronic itching cases and is often underrecognized and misdiagnosed. It can be associated with various conditions such as postherpetic pruritus, trigeminal trophic syndrome, anogenital pruritus, scalp dysesthesia, nerve compression syndromes, small-fiber neuropathy, and disorders affecting the central nervous system. Diagnosis involves medical history, physical examination, laboratory tests, skin biopsy, and radiological and functional evaluations. Treatment options include neuroleptics, topical capsaicin, epidural steroid injections, botulinum injections, nerve blocks, and neurostimulation techniques, but success rates vary. A multidisciplinary approach involving general practitioners, dermatologists, neurologists, and physiotherapists is recommended for managing this condition.