Evaluation of the Antipruritic Effects of Topical Pimecrolimus in Non-Atopic Prurigo Nodularis: Results of a Randomized, Hydrocortisone-Controlled, Double-Blind Phase II Trial

Abstract

Background: In the treatment of atopic dermatitis, pimecrolimus has high antipruritic effects. Objective: To investigate the efficacy of 1% pimecrolimus cream in comparison to 1% hydrocortisone cream in non-atopic prurigo nodularis (PN). Methods: A randomized, controlled, double-blind study with intraindividual randomization was done in 30 patients (17 females, 13 males; mean age 58.5 years) with PN. Results: Pruritus intensity decreased significantly (p < 0.001) on both treated sides as early as after 10 days of treatment; scratch lesions improved (p < 0.001). Quality of life as assessed by the Dermatology Life Quality Index improved significantly. However, a significant advantage of pimecrolimus over hydrocortisone was not found. Conclusion: The results suggest that the non-steroid pimecrolimus is an effective alternative for PN treatment.

Health-Related Quality of Life in Chronic Pruritus: An Analysis Related to Disease Etiology, Clinical Skin Conditions and Itch Intensity

“…Also, no previous study investigated DLQI in a large number of PN patients except in single trials. For example, Siepmann et al [27] used DLQI in a randomized controlled trial and demonstrated DLQI values >11 in all PN patients.…”

Prurigo Activity Score (PAS): validity and reliability of a new instrument to monitor chronic prurigo

“…Basis for the development of PAS were the earlier applied PRUNOSI and SSS scores . The PAS questionnaire version 0.9 consists of 7 items (Table ).…”

“…However, none of these scales were validated or used in subsequent trials. So far, we used preliminary versions of a prurigo score (PRUNOSI, Scratch Symptom Score (SSS)) in two clinical studies (ClinicalTrials.gov: NCT00507832, German Register Clinical Trials: DRKS00005284) . PRUNOSI evaluated the type (papules, nodules, lichenification, excoriations and crusts) and percentage of lesions in affected body areas versus the whole body area.…”

“…In one of these studies, we compared atopic dermatitis to CPG and detected a significant difference in the score between these two groups . In the other double‐blind, randomised, controlled study, in which the antipruritic effect of topical pimecrolimus versus topical hydrocortisone in non‐atopic CPG was evaluated, PRUNOSI showed a significant score difference before and after the therapy . The first signs of CPG improvement were healing of excoriations, crusts and erythema .…”

Unusual Case of Pruritus Vulvae (Prurigo Nodularis): A Rare Case Report

“…12 Habit reversal therapy for the itchscratch cycle may be helpful and can be administered by dermatology nurses trained in this therapy. Cryotherapy with liquid nitrogen helps reduce pruritus and flatten lesions.…”