Prurigo nodularis

Williams, Kyle; Huang, Amy; Belzberg, Micah; Kwatra, Shawn G.

doi:10.1016/j.jaad.2020.04.182

Cited by 101 publications

(113 citation statements)

References 53 publications

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“…Chronic prurigo (CPG) is a rare but worldwide occurring disease ( 1 , 2 ). It is characterized by the presence of chronic pruritus (CP), history, and/or evidence of repeated scratching (e.g., excoriations, scars) as well as localized or generalized pruriginous lesions ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Chronic Prurigo: Similar Clinical Profile and Burden Across Clinical Phenotypes

2021

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Chronic prurigo is a debilitating skin disease characterized by the presence of chronic pruritus and scratching-related pruriginous lesions. The pruriginous lesions can differ in their clinics what has recently been categorized into different clinical phenotypes. The most common one is chronic nodular prurigo (syn. prurigo nodularis); other phenotypes are papular, plaque, umbilicated, and linear prurigo. A comparison between these phenotypes regarding similarities and differences has not yet been performed. In this explorative analysis, itch characteristics, scratching behavior, and disease burden of the nodular, papular, plaque, and umbilicated prurigo were investigated in 1,128 patients. Patients with nodular and plaque prurigo were younger than patients with papular and umbilicated prurigo. The shortest duration of the underlying pruritus was found in papular and umbilicated prurigo, the longest in plaque prurigo. Itch intensity, impairment of sleep, mood and the quality of life did not differ. These findings confirm that the clinical phenotypes of chronic prurigo belong to a spectrum of one disease with similar disease characteristics and can be categorized under the umbrella term of chronic prurigo. Future clinical trials should include all phenotypes of chronic prurigo.

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Section: Introductionmentioning

confidence: 99%

Chronic Prurigo: Similar Clinical Profile and Burden Across Clinical Phenotypes

2021

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“…Th2-type cytokines, such as IL-4, IL-13, and IL-31, are closely involved in inflammatory responses and chronic pruritus formation in local skin lesions of PN [4] . There are no standardized diagnostic and therapeutic guidelines for the treatment of PN [5] . For this patient with recurrent disease and poor response to conventional therapy, there is currently no appropriate treatment [6] .…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Dupilumab for Recurrent Prurigo Nodularis: A Case Report and Review of the Literature

2023

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Prurigo nodularis (PN) is a chronic inflammatory skin disease that affects the quality of life of patients and is classified in the ICD-10 as a group of chronic lichen simplex and itchy skin diseases (ICD-10/L28) with an incidence of approximately 36.7-148.53 per 100,000 people. The pathogenesis of PN is closely related to type 2 inflammatory response. There are no standardized treatment guidelines for this disease, and traditional anti-pruritic treatment regimens often fail to control the vicious pruritic-scratch cycle in PN and have a poor safety profile. Traditional treatment options for PN include oral antihistamines, thalidomide, and topical hormones, calcium phosphatase inhibitors, and other treatments. However, traditional treatment options often suffer from poor pruritus control and high side effects. A patient with prurigo nodularis was admitted to our hospital who responded poorly to routine topical glucocorticoids and other drug therapies and relapsed after discharge from treatment. After readmission, the patient was successfully treated with dupilumab, a biological agent targeting interleukin-4/13. The patient's rash was significantly flattened, and the pruritus NRS score was significantly decreased. In this case, successful treatment of refractory PN with dupilumab could provide new ideas for treatment.

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“…Almost all our patients were taking psychoactive drugs; that might be important; however, in a large series of patients with chronic pruritus in the absence of skin disease, pruritus was found to be iatrogenic in only 7.1% of cases, none of whom was taking benzodiazepine or antidepressants [ 13 ]. On the other hand, antidepressants, such as duloxetine, paroxetine, and fluvoxamine, are also used for the treatment of PN [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairment in Inpatients with Prurigo Nodularis and Psychiatric Comorbidities

Lanza

Cosentino

Ferri

et al. 2021

IJERPH

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Background: Prurigo nodularis (PN) is a chronic refractory itchy dermatosis. Although psychiatric comorbidity is known, research in cognitive impairment is lacking. We evaluated the occurrence and types of cognitive impairment in a series of inpatients with PN. Methods: This was a retrospective chart review of all the patients with PN admitted to a referral neurological institute from September 2018 to March 2021. Any neurological and psychiatric disorder, along with neuroactive drugs taken, were concomitantly assessed. Results: A total of 16 patients with PN (median age: 70 years, two males) were selected from a total of 1806 hospital admissions. Most of them had a neurodegenerative cognitive disorder, from mild cognitive impairment (8) to Alzheimer’s disease (1), followed by mixed disorder (degenerative and vascular) in six and vascular dementia in one. Comorbid psychiatric diseases (anxiety and depression) were more common than either individual condition, followed by bipolar disorder, whereas two patients did not show psychiatric manifestations. Most patients were on combined treatment with benzodiazepines and antidepressants. Conclusion: Cognitive impairment can be observed in PN. In addition to screening for psychiatric comorbidity and initiating appropriate treatment or referral, clinicians may also consider the presence of cognitive impairment in PN of both degenerative and vascular origin.

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Prurigo nodularis

Cited by 101 publications

References 53 publications

Chronic Prurigo: Similar Clinical Profile and Burden Across Clinical Phenotypes

Chronic Prurigo: Similar Clinical Profile and Burden Across Clinical Phenotypes

Dupilumab for Recurrent Prurigo Nodularis: A Case Report and Review of the Literature

Cognitive Impairment in Inpatients with Prurigo Nodularis and Psychiatric Comorbidities

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