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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Itching Sensation Of The Arm After Insect Bite?

Please help!!! We are looking for a specialist in the field of Brachioradial Pruritus. My fiancé was stung by a bee in late June. That quickly turned to cellulitis. Now its a clear case of Brachioradial Pruritus. Only ice packs relieve the itching. Local doctors seem to be miffed and can t give a long term remedy. Three weeks now on gabapentin is not helping. Its localized on the arm and was brought on by a simple bee sting. Can you recommend a specialist or treatment rx?
Fri, 15 May 2020
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General & Family Physician,  's  Response
Hi,

Brachioradial pruritus (BRP) is a localized neuropathic change in sensation of the upper extremities. That exact cause is still not completely understood. However, evidence suggests that cervical spine nerve entrapment or neuropathy due to peripheral nerve injury are the causative underlying problem. However, the good news it is a benign and transient problem.

If I were your treating doctor first I would ask for cervical MRI to rule out cervical radiculpathy. As treatment, I would advise your fiance to avoid his arms to the sun. Ice packs helps. Also topical anti-pruritic medications help. If gabapentin is not helping studies report that oral tricyclic anti-deprassant could help. Moreover, oral medication such risperidone, fluxetine help. These are not antihistamines as antihistamines dont help in this case. Those aforementioned medications should be taken under medical supervision. For this you need expert's guidance by a neurologist.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Ahmad Nazzal, General & Family Physician
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What Causes Itching Sensation Of The Arm After Insect Bite?

Hi, Brachioradial pruritus (BRP) is a localized neuropathic change in sensation of the upper extremities. That exact cause is still not completely understood. However, evidence suggests that cervical spine nerve entrapment or neuropathy due to peripheral nerve injury are the causative underlying problem. However, the good news it is a benign and transient problem. If I were your treating doctor first I would ask for cervical MRI to rule out cervical radiculpathy. As treatment, I would advise your fiance to avoid his arms to the sun. Ice packs helps. Also topical anti-pruritic medications help. If gabapentin is not helping studies report that oral tricyclic anti-deprassant could help. Moreover, oral medication such risperidone, fluxetine help. These are not antihistamines as antihistamines dont help in this case. Those aforementioned medications should be taken under medical supervision. For this you need expert s guidance by a neurologist. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ahmad Nazzal, General & Family Physician