Brachioradial pruritus (sometimes abbreviated BRP) is an intense itching sensation of the arm usually between the wrist and elbow of either or both arms. : 36   The itch can be so intense that affected individuals will scratch their own skin to a bleeding condition. The condition is becoming increasingly common, presenting in patients who are usually fair skinned and middle aged and indulge in golf, tennis, outdoor table tennis, sailing,  or other leisure outdoor activities in sunny climates. : 64 : 402 The cause is not known, although there are a few lines of thought on what causes it. No cure has been found, but depending on severity, good control with treatment can be achieved. For milder cases, the intense itch/scratch cycle can be broken by applying a topical skin coolant gel containing menthol, camphor, or other topical coolant to affected itchy areas, and then consistently applying 100+SPF sunscreen to affected skin of arms, shoulders, neck, etc., whenever they are expected to be exposed to the sun. A unique prescription topical combination of ketamine .5% and amitriptyline hydrochloride 1% has shown immediate and long term relief with no serious adverse events in at least one severe case. [1]
Many different medications and types of topical creams have been experimented with, but few seem to make any difference, except for the above. The application of ice packs to the affected area can also diminish the itch short-term. Causes
Brachioradial pruritus (BRP) is a localized pruritus of the dorsolateral aspect of the arm.
History
Although it had been recognized from as early as the time of the Hippocratic corpus that women in childbed were prone to fevers, the distinct name, "puerperal fever" appears in historical records only from the early 18th century.The death rate for women giving birth decreased in the 20th century in developed countries. The decline may be partly attributed to improved environmental conditions, better obstetrical care, and the use of antibiotics. Another reason appears to be a lessening of the virulence or invasiveness of Streptococcus pyogenes. This organism is also the cause of scarlet fever, which over the same period had declined but has seen a rise in last decade worldwide especially in Asia with smaller outbreaks in US and Canada. UK had reported 12,906 cases between September 2015 and April 2016 which is the largest outbreak since 1969. "The Doctors Plague"
From the 1600s through the mid-to-late 1800s, the majority of childbed fever cases were caused by the doctors themselves. With no knowledge of germs, doctors did not believe hand washing was needed. Hospitals for childbirth became common in the 17th century in many European cities. These "lying-in" hospitals were established at a time when there was no knowledge of antisepsis or epidemiology, and women were subjected to crowding, frequent vaginal examinations, and the use of contaminated instruments, dressings, and bedding. It was common for a doctor to deliver one baby after another, without washing his hands or changing clothes between patients. The first recorded epidemic of puerperal fever occurred at the Hôtel-Dieu de Paris in 1646.