[Chronic prurigo]. / Chronische Prurigo.

Chronic prurigo is a disease characterized by the presence of chronic pruritus and singular or multiple usually hyperkeratotic symmetrically distributed itchy papules, nodules, and/or plaques. This condition is difficult to treat and leads to a substantial impairment of the quality of life. It may originate from dermatological, systemic, neurological, psychiatric/psychosomatic, multifactorial or unknown conditions causing itch, which lead to prolonged scratching behavior and sensitization mechanisms and ultimately to the development of pruriginous lesions. Thorough diagnostic efforts, including a detailed clinical history and physical examination, as well as targeted complementary examinations should be initiated as soon as possible. The German guideline recommends topical steroids and phototherapy as first-choice options. Pimecrolimus and capsaicin (topical), as well as antihistamines, anticonvulsants, and immunosuppressive drugs (systemic) should be considered as valid alternatives.

Generalized eruptive keratoacanthoma with vitiligo followed by the development of prurigo nodularis: A case report and published work review.

Herein, we report a unique case of generalized eruptive keratoacanthoma (GEKA) in a 47-year-old Chinese man presenting with extensive pruritic papules and nodules accompanied by oral lesions. He also had a 2-year history of vitiligo and long-term experience of working outdoors. Biopsies were consistent with keratoacanthoma . Interestingly, prurigo nodularis (PN) was found in histopathology at 1-year follow up. To our knowledge, this is the first report describing a case of GEKA with oral lesions complicated with vitiligo and developed with PN.

Prurigo Nodularis Management.

Characterized by the clinical presentation of individual to multiple symmetrically distributed, hyperkeratotic, and intensely itchy papules and nodules, prurigo nodularis (PN) is a rare disease that emerges in patients with chronic pruritus due to continuous scratching over a long period of time. The itching and scratching of the lesions contribute to the vicious cycle that makes this disease difficult to treat, thus reducing the quality of life of affected patients. The pathogenesis of PN is ambiguous, although immunoneuronal crosstalk is implicated. Its etiology was found to be heterogenous. It can emerge as the symptom of various dermatological, neurological, psychiatric, and systemic diseases. There is currently no approved therapy for PN. However, contemporary therapies consist of calcineurin inhibitors, capsaicin, topical steroids, UV therapy, and a systemic application of antihistamines, anticonvulsants, µ-opioid receptor antagonists, and immunosuppressants. Multimodal therapy should be utilized in order to achieve optimal results, including topical and systemic symptomatic therapies.

Successful treatment of chronic intractable itching using oral pregabalin in a patient with diabetes and systemic prurigo nodularis: a case report of an iliopsoas muscle abscess.

A 73-year-old Japanese man developed chronic intractable itching due to prurigo nodularis. High-dose glucocorticoid ointment failed, and the treatment resulted in poor glycemic control. Repeated scratching caused hematogenous bacterial dissemination via cutaneous injuries, resulting in the formation of iliopsoas and spinal epidural abscesses that required long-term antibiotic treatment. Pregabalin was administered to treat the pruritus, and a considerable improvement was observed. A reduction in the dose and intensity of the topical corticosteroids improved the patient's glycemic control, resulting in the complete resolution of the abscesses. Pregabalin significantly improved the patient's pruritus and decreased the risk of infection.

[Topical cyclosporine in the treatment of ocular actinic prurigo]. / Ciclosporina tópica como tratamiento del prúrigo actínico ocular.

CASE REPORT: A 14-year-old girl from Peru suffered severe limbitis and conjunctivitis. She also presented with clinical skin features diagnosed as actinic prurigo (AP). Her symptoms were successfully controlled with sustained topical therapy of 2% Cyclosporine A. DISCUSSION: AP is an idiopathic photodermatosis that affects mainly the hispanic population of Latin America. There are ocular signs of severe limbitis and conjunctivitis (like atopic keratoconjunctivitis) in 45% of cases. Literature on the subject is very limited and currently topical cyclosporine seems to be the best therapy available.

Use of topical cyclosporin for conjunctival manifestations of actinic prurigo.

PURPOSE: To report the successful treatment of conjunctival manifestations of actinic prurigo with topical cyclosporin. METHODS: A 12-year-old female with extensive limbal lesions and chronic conjunctivitis secondary to actinic prurigo was treated with topical cyclosporin, and a rapid clinical response was observed. RESULTS: The patient had the limbal lesions surgically excised. The lesions completely recurred over the first 2 postoperative months. Treatment with topical steroids and vitamin A ointment was unsuccessful. The patient was then treated with cyclosporine 2% drops and a dramatic improvement occurred. Over a 3-month period, the lesions completely resolved. CONCLUSION: Cyclosporine eyedrops may be an effective treatment for the conjunctival manifestations of actinic prurigo.