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Prurigo Nodularis: Behind the Itch

August 13, 2019

Defining Prurigo Nodularis

Prurigo Nodularis (PN) is a skin condition where hard, itchy lumps form on the skin. Prurigo means itch, and nodularis means nodules. The itching caused by PN can be so intense that people often scratch themselves to the point of bleeding.  The itching is made worse by sweating, heat, or irritation from clothes. If you have symptoms of PN, or have been diagnosed, read on for more info!

The Cause

The itching itself is what causes the nodules to form. When the skin is scratched repeatedly, it causes injury and the skin then protects itself by creating a thicker layer, which is where the nodules come from. This is called the itch-scratch cycle. Although the cause of PN is not always clear, certain conditions will increase the chances of someone developing PN. Some of those include:

  • Psychological conditions
  • Reduced liver or kidney function
  • Allergies
  • Skin diseases such as:

Diagnosis and Treatment

Excessive scratching also causes nerves to thicken in affected areas and these thicker nerves will then send stronger than normal itching sensations. A skin biopsy is usually performed to determine if PN is the cause of the itching, as a biopsy will show the thickened nerves. Other tests, such as blood, liver, and kidney tests, will also help to identify any underlying cause of the itch.

Treatment of PN is different for every patient and it may take several attempts to find a treatment plan that works for you. Common PN treatments are:

  • Corticosteroid Creams are applied to nodules and covered with airtight and waterproof bandages to reduce inflammation.
  • Corticosteroid Injections are injected directly into nodules to reduce inflammation.
  • Oral Corticosteroids are ingested to reduce inflammation.
  • Other Ointments with menthol or phenol cool and soothe itchy skin.
  • Capsaicin Cream uses the heat in your body to block nerve messages.
  • Oral Antihistamines are ingested antihistamines.
  • SSRIs alter serotonin signals in the skin.

Habit reversal therapy is often needed, in addition to medications, to help patients reduce the amount of scratching, which can be very habit-forming. Other treatments can include cryotherapy, photochemotherapy, and immunosuppressants if the common treatments are not effective.

Even with a healthy amount of available treatment options, most people never have a complete resolution of the nodules; therefore, clinical studies to test new treatments are needed to find different and better ways to treat or even cure PN.

ActivMed Practices & Research, Inc. is currently seeking patients interested in helping to evaluate new options that may potentially help treat certain PN symptoms. Qualified candidates who participate will receive study-related care at no cost.  Compensation is available for travel.  If you or someone you know is suffering from the chronic itch and nodules associated with PN, this study may be a great opportunity.  To learn more and to see how you or someone you love may qualify for a PN study, please click HERE.

 

References:

https://www.aocd.org/page/PrurigoNodularis

https://rarediseases.info.nih.gov/diseases/7480/prurigo-nodularis

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