Xerosis cutis and associated co-factors in women with prurigo nodularis

Abstract

BackgroundCurrent data regarding the associated factors of prurigo nodularis are still uncertain, except for atopic predisposition.ObjectivesThe purposes of this study were to (1) determine the frequencies of xerosis and other accompanying diseases of female patients with prurigo nodularis; (2) compare the demographic, clinical and accompanying disease characteristics by grouping these patients according to whether they have associated xerosis (who were subsequently subgrouped as atopic or non-atopic) or not.MethodsIn this retrospective descriptive study, 80 females with PN were categorized according to the accompanying diseases (dermatological, systemic, neurological, psychogenic, mixed, or undetermined origin).ResultsA total of 45 associated co-factors including dermatological in 63 (78.8%), systemic in 57 (71.3%), psychological in 33 (41.3%) and neurological co-factors in 14 (17.5%) of all patients with prurigo nodularis were detected. Xerosis was observed in 48 (60%) patients (non-atopic co-factors in 66.7% of them). The ratio of patients with mixed co-factors, dermatological+systemic co-factors and dermatological+systemic+psychological co-factors were found to be significantly higher in patients with xerosis compared to those without xerosis.Study limitationsOur study has certain limitations such as the absence of an age-matched control group, absence of follow-up data and the fact that the diagnosis of xerosis has not been based on objective methods.ConclusionsXerosis has been identified in more than half of the patients with PN and it has been determined that in most patients xerosis is associated especially with diabetes mellitus and other conditions related to prurigo nodularis.

Diagnostic Workup and Evaluation of Patients with Prurigo Nodularis

“…One study found that 60% of its cohort of patients with PN (n = 80) had xerosis. In these patients with xerosis, there were higher rates of co-morbidities including diabetes and psychiatric causes, which is discussed below [21].…”

“…Some studies have pointed to dermatological conditions as the predominant etiology of PN, up to 82% [5,19]. PN has been associated with a variety of dermatological conditions, most notably atopic dermatitis (up to 46%) [5,[19][20][21][22]. Other dermatological conditions that have been associated with PN are cutaneous T-cell lymphoma, lichen planus, xerosis cutis, keratoacanthomas, and bullous pemphigoid [5,23,24].…”

<p>Treatment-resistant prurigo nodularis: challenges and solutions</p>

“…Overwhelmingly, the most common skin finding in patients receiving hemodialysis was xerosis cutis 42. In a recent study, 60% of female patients with PN had concomitant xerosis cutis, 66% of which was from a nonatopic underlying condition 43. These patients were more likely to see PN development at a later age and to have multiple underlying conditions associated with PN 43.…”

“…In a recent study, 60% of female patients with PN had concomitant xerosis cutis, 66% of which was from a nonatopic underlying condition 43. These patients were more likely to see PN development at a later age and to have multiple underlying conditions associated with PN 43. The most common diseases associated with this rare PN subtype were chronic kidney disease and diabetes mellitus 44…”

Keratin 17 is induced in prurigo nodularis lesions

“…Recently, PN was defined as a subtype of chronic prurigo and may possibly be triggered by neuronal sensitization to itch and the development of an itch-scratch cycle [3]. Various disorders have been considered to be linked to PN (e.g., atopic predisposition, systemic diseases, infections, neurological disorders, xerosis cutis, and psychiatric comorbidities) [1,[4][5][6][7][8][9][10]. However, its exact pathophysiology remains unclear.…”