Cutaneous sensory disorder (CSD) represents a heterogeneous clinical situation where the
patient presents with either disagreeable skin sensations (ie, itching, burning, stinging) or
pain (ie, allodynia) and/or negative sensory symptoms (ie, numbness, hypoaesthesia).
These patients have no apparent diagnosable dermatologic or medical condition that
explains the cutaneous symptom, and typically have negative findings upon medical
workup. Skin regions that normally have a greater density of epidermal innervation tend to
be more susceptible to the development of CSD. CSDs can affect any body region but
generally tend to be confined to the face, scalp and perineum, and have been referred to in
the literature with region-specific terms such as burning mouth syndrome, glossodynia and
vulvodynia. Symptoms such as pruritus with unexplained hyperhidrosis may occur during
sleep, as a result of heightened sympathetic tone. Sleep deprivation and insomnia can play
a moderating role in CSD. Somatization and dissociation can play a central role in the
pathogenesis of CSDs. A review of the literature suggests that CSDs represent a complex,
and often poorly understood interplay between neurobiological factors associated with
neuropathic pain, neuropathic itch and neurologic/neuropsychiatric states (eg, radiculopathies,
stroke, depression and posttraumatic stress disorder). These neurologic/neuropsychiatric
states can modulate pain and itch perception by potentially affecting the pain and
itch pathways at a structural and/or functional level.
Semin Cutan Med Surg 32:110-118 © 2013 Frontline Medical Communications
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