Ward et al reported diagnostic criteria for multilevel symmetric neuropathic pruritus (MSNP). The authors are from Indiana University and Wright State University.

Criteria for multilevel symmetric neuropathic pruritus:

(1) age > 60 years of age

(2) body mass index (BMI) > 25 kilograms per square meter

(3) well-delineated symmetric areas of pruritus involving extremities and trunk

(4) degenerative disc disease, with degenerative vertebral changes on spinal imaging studies

(5) history of, or significant risk factors for, atherosclerosis

(6) improvement after gabapentin therapy


The diagnosis requires exclusion of other causes of pruritus.

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