Prurigo nodularis

• red or pink raised nodular ,ulcerate, with symmetrical distribution (usually lateral aspects of the arms and legs, shoulders, chest, and buttocks)

• Healed lesions can leave a scar or discolouration

Key points

• The diagnostic workup : CBC ,LFT ,Cr

• Obtaining a skin biopsy specimen is indicated in subsets of patients

• Treatment for prurigo nodularis is centered on 

  1. topical, 

  2. intralesional, 

  3. systemic neuroimmune modulatory therapies 

to break a short-circuited itch–scratch cycle

association with

• Atopy (predisposition to asthma, atopic dermatitis, and hay fever)

• Drugs that produce chronic itch such as antimalarials, opioids, and targeted cancer treatments

• Internal disease such as:

  • Cancer

  • Diabetes

  • Liver disease

  • Chronic kidney disease

  • HIV/AIDS

  • Thyroid disorders.