Prurigo Nodularis and Its Management.

Prurigo nodularis occurs with chronic pruritus and the presence of single to multiple symmetrically distributed, hyperkeratotic, and intensively itching nodules. Diverse dermatologic, systemic, neurologic, or psychiatric conditions can lead to prurigo nodularis. Structural analysis demonstrated a reduced intraepidermal nerve fiber density and increased dermal levels of nerve growth factor and neuropeptides such as substance P and calcitonin gene-related peptide. Novel therapy concepts such as inhibitors at neurokinin-1, opioid receptors, and interleukin-31 receptors have been developed. The mainstays of prurigo nodularis therapy comprise topical steroids, capsaicin, calcineurin inhibitors, phototherapy, and the systemic application of anticonvulsants, µ-opioid receptor antagonists, or immunosuppressants.

[Prurigo]. / Les prurigos.

Prurigo is a medical term which includes several clinical, pathological and etiologic entities. Diagnostic and therapeutic management is different depending on if we face acute prurigo or chronic prurigo. Acute prurigo is almost always linked to parasites or insects. Chronic prurigo can be linked to dermatologic diseases or may reveal internal pathologies. Complementary exams we should ask for are focused on these diseases. Idiopathic chronic prurigo, without underlying disease, is the most frequent one. It needs regular survey, as it can reveal cutaneous or internal diseases after months or even years. Treatment of prurigo is treatment of the underlying disease. Symptomatic treatment against pruritus, topic or systemic, must be added.