RESUMO
Prurigo nodularis is a chronic skin condition characterized by severely pruritic nodules that cause a profound negative impact on quality of life. The second article in this 2-part continuing medical education series focuses on reviewing the pathogenesis of prurigo nodularis and exploring management algorithms for this condition. In addition, we discuss some emerging and novel therapies for treating prurigo nodularis. The first article in this 2-part series describes the broader epidemiology, patient demographics, physical examination findings, and symptoms to aid in the timely recognition and diagnosis of prurigo nodularis.
Assuntos
Prurigo/etiologia , Prurigo/terapia , Administração Cutânea , Administração Oral , Antidepressivos/administração & dosagem , Antipruriginosos/administração & dosagem , Biópsia , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Doença Crônica/psicologia , Doença Crônica/terapia , Diagnóstico Diferencial , Humanos , Imunossupressores/administração & dosagem , Anamnese , Proteínas do Tecido Nervoso/metabolismo , Vias Neurais/imunologia , Fototerapia/métodos , Prurigo/diagnóstico , Prurigo/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Receptores de Fator de Crescimento Neural/metabolismo , Índice de Gravidade de Doença , Pele/imunologia , Pele/inervação , Pele/patologia , Substância P/metabolismo , Terapias em Estudo/métodos , Resultado do TratamentoRESUMO
Emotional tensions in predisposed subjects may play a key role in inducing a pruritic sensation, leading to a scratching that, becoming a self-perpetuating pathomechanism, may represent the main feature of two distinct cutaneous clinical entities: prurigo nodularis and lichen simplex chronicus. Psychogenic factors play a relevant role in both conditions, and they are often associated with depression and dissociative experiences. Hence, the importance of the evaluation of these patients from the point of view of psychodermatology, which may analyze the relationship between skin disease and psychological factors. Patients with real or perceived imperfections in particular areas of the body (face, scalp, hands, and genital area) are more prone to psychologic distress, whereas cutaneous diseases may lead to experience a heightened level of distress. As psychosomatic factors have been estimated to be present in at least one-third of dermatologic patients, effective management of skin conditions involves consideration of the associated emotional factors.