Altered manifestations of skin disease at sites affected by neurological deficit - PubMed (original) (raw)

Review

. 2015 Apr;172(4):988-93.

doi: 10.1111/bjd.13352. Epub 2015 Feb 25.

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Review

Altered manifestations of skin disease at sites affected by neurological deficit

E Azimi et al. Br J Dermatol. 2015 Apr.

Abstract

Background: The contribution of the nervous system to inflammation in general and inflammatory skin disease in particular has been underappreciated. It is now apparent that an intact neural component is required for the conventional clinical manifestations of many inflammatory skin diseases.

Objectives: To investigate the relationship between nerve damage and skin disease.

Methods: Previous individual reports since 1966 were collected systematically and the clinical observations described therein were placed within current concepts of neurogenic inflammation.

Results: We reviewed the literature and identified 23 cases of alterations in the appearance or distribution of skin disorders in patients with acquired central or peripheral neural damage or dysfunction. In 19 cases, near or complete resolution of pre-existing skin lesions occurred in areas directly or indirectly supplied by a subsequently injured nervous system. Exacerbation or new onset of skin lesions occurred in only four cases. The neural deficits described included damage within the peripheral or central nervous system resulting in pure sensory, pure motor or combined sensory and motor deficits.

Conclusions: These cases highlight the importance of neural innervation and neurogenic inflammation in the development of inflammatory skin disease and prompt further examination of the use of neural blockade as an adjunctive therapy in the treatment of inflammatory dermatoses.

© 2014 British Association of Dermatologists.

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Conflict of interest statement

The authors have no conflicts of interest or financial disclosures to declare.

Figures

Figure 1

Figure 1

Altered manifestation of psoriasis following nerve injury. Top: Photograph showing remission of psoriasis in the right hand following posterior dislocation of the right shoulder that resulted in a brachial plexus neurapraxia in the distribution of the radial and median nerves. Psoriasis lesions remained intact on the left hand. The patient was not receiving any treatments for his skin lesions preceding or during this time. Bottom: Reappearance of psoriasis lesions in the right hand during early stages of recovery from peripheral nerve injury, approximately 4 months following his accident. Photogrpahs from reference #34.

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