# Neuropathic Pain Masquerading as Dermatologic Symptoms: A Case of Misleading Cutaneous Presentation

## TL;DR

A patient's skin-like symptoms were actually caused by nerve issues, showing the need to consider neurological problems in dermatology.

## Contribution

Highlights a case where neuropathic pain was misdiagnosed as a dermatologic condition.

## Key findings

- The patient's skin symptoms improved with treatment, but pain persisted.
- Neurological evaluation revealed lumbar spine degeneration causing the pain.
- The case emphasizes the need for interdisciplinary collaboration in diagnosis.

## Abstract

Neuropathic pain presenting as dermatologic symptoms can occur when damaged or dysfunctional nerves manifest with symptoms that resemble skin-related conditions. We present a case of a 62-year-old male who presented with burning pain and redness in the perineum and gluteal cleft. Initially, the patient was treated for dermatologic symptoms, resulting in the resolution of erythema. However, the pain persisted, prompting a neurologic workup. Despite the improvement of skin symptoms, the patient's pain persisted, prompting a neurological workup. Diagnostic imaging revealed significant degenerative changes in the lumbar spine, supporting a neuropathic etiology. This case highlights the importance of considering neurologic disorders in dermatologic practice, especially when cutaneous symptoms persist despite appropriate dermatological treatments.