Chronic Nodular Prurigo: A European Cross-sectional Study of Patient Perspectives on Therapeutic Goals and Satisfaction

Abstract

Chronic nodular prurigo is characterized by recalcitrant itch. Patient perspectives on therapeutic goals, satisfaction with therapy and efficacy of therapeutic regimens for this condition are unknown. This questionnaire study examined these issues in 406 patients with chronic nodular prurigo from 15 European dermatological centres. Improvements in itch, skin lesions and sleep were the most important goals. Emollients, topical corticosteroids and antihistamines were the most frequently used treatments, while a minority of patients were prescribed potent medications, such as systemic immunosuppressants and gabapentinoids. Most patients were not satisfied with their previous therapy (56.8%), while 9.8% did not receive any therapy despite having active disease. A substantial number of respondents (28.7%) considered none of the therapeutic options effective. Although chronic nodular prurigo is a severe disease, most patients were not treated with potent systemic drugs, which may contribute to the high levels of dissatisfaction and disbelief in available therapies. Specific guidelines for chronic nodular prurigo and the development of novel therapies are necessary to improve care.

Prevalence, incidence and presence of comorbidities in patients with prurigo and pruritus in Germany: A population‐based claims data analysis

“…3 Moreover, patients also suffer from insufficient treatment options and the lesions can take multiple months or years to heal. 4,5 To date, there have not been many valid publications on the prevalence of prurigo in a majority of countries. 6,7 In particular, there are no published population-based data on prurigo epidemiology in Germany, except for one report focused on prurigo nodularis.…”

Rosacea and upper gastrointestinal disorders: a case‐control study from a large, urban academic centre

“…This nosological confusion could be explained by clinical similarities with inflammatory acne vulgaris (but without comedones) and with these two infectious folliculitis, that is, a monomorphic papulo-pustular rash affecting the upper trunk, neck and face. [5][6][7] Moreover, cases of facial demodecidosis and rosacea have been documented under glucocorticoids therapy. 8 Similarly, Yu et␣al.…”

Worst itch numerical rating scale for prurigo nodularis: a psychometric evaluation

“…The burden of pruritus is greater in patients with PN than in patients with non‐lesional chronic pruritus, 6 and patients with inflamed or excoriated nodules, health‐related quality‐of‐life impairments and psychological impacts are less likely than patients without these factors to respond to treatment 7 . Since pruritus is such a dominant symptom in PN, the primary goal of patient management is reducing the symptom 8 . The assessment of pruritus in PN is based on subjective patient‐reported scales, most commonly the numeric rating scale (NRS) 9 .…”