POSTER TITLE: PARESTHETIC NEURALGIA Reason for Consultation: A 51-year-old woman presents with localized itching on her back that has been evolving over time, with a brownish skin lesion. Physical Examination: Smooth hyperpigmented area on the right scapular region with excoriation due to scratching. Altered sensation (hyperesthesia). Diagnostic Orientation: Dorsal sensory neuropathy caused by compression or irritation of the dorsal branches of the spinal nerves, manifesting as localized itching and secondary lesions. The diagnosis is usually clinical; MRI and other tests are only useful if vertebral pathology is suspected. Treatment: General measures: avoid heat, friction, and keep the skin hydrated. Topical treatment: capsaicin. Pharmacological treatment: gabapentin. Conclusions: This is an underdiagnosed condition that should be considered in patients with chronic localized itching (>6 weeks) in the scapular region and secondary hyperpigmentation due to scratching, without infiltration into primary dermatological lesions. The clinical diagnosis remains the main tool, and recognizing it early can improve patient outcomes by offering potential treatments to improve the patient's quality of life.This article presents a primary care case of paresthetic notalgia, highlighting the diagnosis, management, and strategies to improve patient quality of life, while contributing to clinical knowledge in family medicine.This article is original, based on observations from a clinical caseThis case highlights the importance of considering paresthetic notalgia in patients with chronic localized pruritus, reinforcing the value of careful clinical evaluation and timely management.Paresthetic notalgia is often underdiagnosed in primary care. Early recognition allows for effective management and improved patient outcomes, emphasizing the need for clinical awareness of this conditionThis article presents a clinical case from primary care to highlight the diagnosis and management of paresthetic notalgia, a frequently underdiagnosed condition. It emphasizes recognizing chronic localized pruritus with secondary lesions, and discusses management strategies to improve patient quality of life, contributing to clinical knowledge in family medicine