DOI: https://doi.org/10.36347/sasjm.2026.v12i07.001

Pages: 706-709

Background: Brachioradial pruritus (BRP) is a neuropathic condition characterised by localised, intense pruritus in the dorsolateral aspects of the upper limbs, due to cervical spine disease. It is routinely mistaken for a primary inflammatory skin disorder in primary care settings, which results in delayed diagnosis & thus timely management, adversely affecting patients’ quality of life. It is often linked aetiologically to mild cervical nerve root compression with or without significant foraminal stenosis in the literature. Methods: A 67-year-old Caucasian woman presented with a seven-month history of intense pruritus, numbness, and a tingling rash over the right shoulder corresponding to a C6 dermatomal distribution. The rash worsened in the summer & subsided in the winter months. Her GP had prescribed three different empirical treatments for eczema to no avail. She underwent haematological, biochemical, and autoimmune blood screen and a cervical spine MRI was subsequently performed. Findings: All inflammatory markers and the autoimmune screen came back as normal. The patient had independently self-identified her diagnosis & presented to the GP, prior to specialist consultation. She was then referred to the neurologist who then arranged a cervical MRI. This showed multilevel cervical degenerative disease at C5–C8 with osteophytes causing mild nerve root compression at C5 and C6, without significant foraminal stenosis. Gabapentin 300 mg twice daily was initiated alongside physiotherapy, topical capsaicin & she was given strict photoprotection advice. After only 6 weeks of targeted therapy, she demonstrated a 70% reduction in pruritus severity, with a significant resolution of the erythematous rash. Interpretation: BRP can arise from mild cervical nerve root compression without significant foraminal stenosis. A characteristic non-response to topical corticosteroids and antihistamines indicates the diagnosis. The clinical triad of dermatomal pruritus, neuropathic