Solar Pruritus of the Elbows (Brachioradial Summer Pruritus)

Severe pruritus of the lateral aspect of the elbow, without eruption, appears infrequently as a peculiar response to sunlight. Affecting a strictly limited area of the skin overlying the proximal portion of the brachioradialis muscle, it is charcterized by summer recurrences or exacerbations, intensification during the day, and subsidence at night. Most patients are outdoor workers in their 30's 40's and 50's, and usually their left side is affected alone or predominantly. The disorder is confused with, but distinguishable from, psychogenic pruritus. Histopathologic examination of one case was unrevealing except for mild actinic damage and pilosebaceous atrophy, changes which prompt the conjecture that xerosis of the skin of the elbow may promote itching when strongly stimulated by sunlight.