Patients with nodular prurigo commonly have pre‐existing psychological disease that requires treatment concomitant with cutaneous therapies

Abstract

causality inferences. It is possible that ascertainment bias was present.In conclusion, survivors of cancer, especially survivors of haematological malignancies, had a higher co-occurrence of psoriasis. There is a high risk that the findings are due to surveillance bias. The relative contributions of initial misdiagnosis and possible effects of systemic medication on the immune system need further study.

Cutaneous Squamous Cell Carcinoma Mimickers: Beware the Pruritic Papule on the Leg of an Older Female

“…In our experience, we have found doxepin, a tricyclic antidepressant, and strong H1 antagonist, to be a highly effective antipruritic agent in these patients, perhaps as it treats both histamine effects and underlying mood disorders [ 14 , 15 ]. Doxepin therapy should be initiated at a low dose and titrated to the patient’s response, and involving the patient’s primary care physician is often helpful in this regard.…”

Chronic prurigo

“…The prevalence of pre‐existing psychiatric disorders was found to be higher in patients with prurigo nodularis than in patients with other dermatological diseases in a psychodermatology expert centre 26 . Patients with prurigo nodularis aged 40–69 years were four times more likely than controls to have a diagnosis of malignancy 27 .…”

“…The prevalence of pre-existing psychiatric disorders was found to be higher in patients with prurigo nodularis than in patients with other dermatological diseases in a psychodermatology expert centre. 26 Patients with prurigo nodularis aged 40-69 years were four times more likely than controls to have a diagnosis of malignancy. 27 A German study found that adults with prurigo suffered more frequently from hypertension (35Á16%), hyperlipidaemia (24Á95%) and depression (21Á97%) than the general population (P < 0Á001).…”

Response to ‘Patients with nodular prurigo commonly have pre-existing psychological disease that requires treatment concomitant with cutaneous therapies’

“…DEAR EDITOR, We read with interest the study by Pathmarajah et al on the treatment of nodular prurigo (NP) and applaud the team's emphasis on 'treatments that manage the skin and the mind concurrently'. 1 This is a sentiment echoed within our dermatology service. We have demonstrated improvements in patients' symptoms, quality of life (QOL) and mental health rating scores with a 6-week experiential course in awareness meditation delivered within our department.…”

“…We recognize that meditation is not for everyone or indeed intended as monotherapy, but rather we see it as an adjunctive therapy requiring initial specific resources that may provide benefit to a subgroup of participants. Pathmarajah et al 1 highlight the distress in their patients, the variety of treatments required to manage symptoms, and how challenging it is to induce remission. Coupled with the paucity of psychological supports available, we may be forced to develop and deliver new ways to reach those most in need.…”