What Is Prurigo Nodularis and Its Treatment or Management Options?

 Prurigo nodularis is a chronic disorder of the skin that is classically seen as multiple, firm, flesh to pink colored papules, plaques, and nodules commonly located on the extensor surfaces of the extremities. The lesions are very pruritic and can occur in any age group.

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.

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. These conditions will increase the chances of someone's serious health issues. It includes:

• Psychological conditions

• Reduced liver or kidney function

• Allergies

• Skin diseases such as:

• Eczema

• Bullous Pemphigoid

• Dermatitis Herpetiformis

It is commonly associated with another disease such as atopic dermatitis or any dermatoses associated with chronic pruritus. The diagnosis is chiefly Prurigo Nodularis clinical trials.

Let's look at the best Treatment or Management Options for Prurigo Nodular:

Management of Prurigo nodularis requires a multifaceted approach. Patients need to be educated on practices to reduce scratching of lesions, assurance, and diagnosing of underlying causes of pruritus. 

General Care:

If you are suffering from this Prurigo nodularis chronic disorder, then you should

 

• Stay in a cool and comfortable environment.

• Applying emollients multiple times a day to keep skin moisturized.

• Use gentle bath soap, shampoo, and other cleansers.

• Keep your nails short.

• Wear protective clothing, such as long sleeves, shirts, or gloves.

• Keep your scratches covered with bandages.

• Reduce Stress.

Specific Care:

Antihistamines and Leukotriene Inhibitors

High dose non sedating antihistamines for daytime followed by First-generation sedating antihistamines at bedtime. A combination of fexofenadine and montelukast gives good results. Common adverse reactions to antihistamines are drowsiness, dizziness, and weakness.

Phototherapy/Excimer:

• Phototherapy with PUVA, including bath/topical PUVA, long-wavelength ultraviolet A, narrowband ultraviolet B, and monochromatic excimer light of 308 nm, have been used and shown improvement of Prurigo nodularis nodules in patients.

• Narrow Band UVB phototherapy results in significant improvement in Prurigo nodularis at an average dose.

• An excimer laser is more beneficial than topical clobetasol.

Topical and Intralesional Therapy:

Topical, oral, and intralesional corticosteroids have all been used in prurigo nodularis to decrease inflammation and sense of itching and soften and smooth out firm nodules. The improvement with corticosteroids is variable, and corticosteroids. Intralesional corticosteroid (usually triamcinolone acetonide) treatment is commonly used in resistant cases to a limited extent. Triamcinolone acetonide concentrations as low as 2.5 mg/mL may be effective, although more scarred pruriginous lesions may require higher concentrations. A total dose of 20 mg for adults every 3-4 weeks is safe for patients without diabetes mellitus or hypertension. An 8-am serum cortisol test can be performed if concerns exist about adrenal suppression.