Brachioradial Pruritus Case Misdiagnosed for a Decade: Cervical Nerve Compression and New Hypotheses for Seasonality, Capsaicin Response, and Icing

Idiopathic itching of the upper extremities or scapula is a seemingly dermatological condition confounded by an unexplained connection to ultraviolet (UV) exposure that together conspire to mask a frequent etiology in cervical nerve compression. This underlying cause is not commonly recognized outside of certain specialties, nor is it included in skin-related screening algorithms for general practitioners, resulting, together with frustratingly nonspecific diagnostic tools, in protracted suffering of patients. A case study reported here suggests synergistic diagnostic and treatment approaches that reflect the role of cervical nerve compression, including radiography, capsaicin response, and physical therapy. The patient experience supports an alternative hypothesis, occupational seasonality, to account for the apparent UV connection that should be evaluated in new epidemiological research that better isolates brachioradial pruritus from conditions with superficially similar presentations.