Prurigo Nodularis

Overview

Prurigo nodularis (PN) is a chronic, inflammatory skin disease characterized by intense itching and symmetrically distributed, firm papules or nodules. Its pathology involves epidermal barrier defects, type 2 immune inflammation, and neural remodeling. Management is stepwise and multimodal, ranging from topical corticosteroids and phototherapy to biologics targeting the type 2 inflammatory pathway, and should address associated systemic, neurological, and psychological factors to break the itch-scratch cycle.

Symptoms

• Intense itching
• Dome-shaped nodules
• Hyperkeratosis
• Excoriations

Treatment

Avoid scratching; apply potent topical corticosteroids or intralesional injections, and take oral antihistamines for severe itching.

Dietary advice

Eat a bland diet and avoid spicy and allergenic foods.