Neuropathic Skin Disorders

Neuropathic skin disorders are a type of peripheral neuropathy, which is a medical problem that results from the abnormal functioning of sensory nerves in the peripheral nervous system, including skin, muscles and connective tissues within the musculoskeletal system. Neuropathic skin disorders can also result from problems within the central nervous system (the brain and spinal cord).

Sensory Nerve Involvement

• Whether its origin is due to compression or damage to peripheral pain receptors within the skin, muscular or connective tissues, or if it originates in dysfunction within the central nervous system, neuropathic skin disorders involve changes and abnormal functioning of nerves that carry sensations to and fro between the skin and the central nervous system.

Symptoms

• Symptoms include pain in response to a non-painful stimulus (allodynia), abnormal unpleasant sensations (dysesthesia), increased sensitivity to painful stimuli (hyperalgesia), inflammation of nerves (neuritis), pain in the distribution of nerves (neuralgia) and spontaneous or evoked abnormal sensations (paresthesia).

Additional Manifestations

• People with neuropathic skin disorder describe a variety of painful or uncomfortable sensations. They may report tingling, numbness, burning, electric, crawling sensations and "shooting" pain. Sometimes inflammation in the form of rashes, redness and bumps will appear. Sometimes, as in complex regional pain syndromes, affected tissue will be several degrees warmer than surrounding tissue.

Causes

• Nutritional deficiencies, chemotherapy, drugs, surgery, trauma, systemic diseases such as lyme disease, rheumatoid arthritis, sarcoiodosis, syphilis, AIDS, hepatitis, diphtheria, diabetes, Friedreich's ataxia, cerebrovascular accident, excessive alcohol, toxins, infections, inflammations, decreased oxygen and blood flow, prolonged pressure on nerves and nerve compression are among the many possible causes of neuropathic skin disorders.

Treatment

• Analgesics (pain relievers) and opiates can be partially effective in tempering pain and discomfort. However, the complex causes and involvement of both peripheral and central nervous systems generally demand more involved treatment. Pharmacologic treatment can include antidepressants, antianxiety medications, anticonvulsants, antispasmodics, phenothiazines, neuroleptics and topical and local agents such as capsaicin, topical aspirin and lidocaine.