Extensive Prurigo Nodularis: Characterization and Etiology

Abstract

Background/Aims: Prurigo nodularis (PN) has multiple reported disease associations, and this study analyzes the demographics, clinical distribution and underlying etiologies in an Asian cohort. Methods: A 1-year retrospective study was carried out on PN patients with extensive lesions (≥10) who attended a specialized itch clinic. Results: 37 patients (46% male, median age 53 years) were included. In all patients, an underlying etiologic factor associated with pruritus could be identified. 49% (n = 18) of patients had a single attributable etiology, whilst 51% (n = 19) had multiple etiologies. Among all patients, dermatological disease was the most common cause (82%), of which endogenous eczema comprised the majority of cases (54%), followed by systemic disease (38%). Conclusions: All patients with extensive PN had identifiable factors associated with pruritus in this study, and a dermatological condition was the predominant etiology in both patients with mono- and multifactorial disease. A significant number of patients had underlying systemic causes.

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

“…Due to scratching, acute and chronic scratch lesions may occur. Chronic scratch lesions such as prurigo nodularis (PN) or lichen simplex may generate itch by themselves and are frequently unresponsive to therapy, thus prolonging the course of the disease [24]. Due to their biological behavior, they were frequently considered in the past as being entities of their own.…”

Chronische Prurigo: eine ungewöhnliche Manifestation des Hodgkin-Lymphoms

“…Im Zuge dessen könnten sich Patienten auch vernachlässigt fühlen und das Vertrauen in die Ärzte verlieren, was wiederum zu einer unzureichenden weiteren Versorgung führen könnte. Schon in früheren Publikationen steht, dass eine generalisierte PN ohne primäre Dermatose Untersuchungen zum Ausschluss systemischer Erkrankungen einschließlich von neoplastischem Pruritus erforderlich macht [7]. Selbst bei Verdacht auf einen psychischen Ursprung ohne sonstige erkennbare Ätiologie trotz umfassender Untersuchungen sollten Ärzte ein relativ breites Spektrum von Differenzialdiagnosen im Blick behalten und auf jegliche neuen klinischen Zeichen achten, z.B.…”

Methotrexate for refractory prurigo nodularis

“…Beside that histological investigation is a useful confirmatory diagnostic tool. Further investigations to rule out any underlying systemic causes of pruritus are crucial such as CBC, liver function test, and creatinine and TFT [4][5][6][7].…”