TY - JOUR
T1 - Practical approaches for diagnosis and management of prurigo nodularis
T2 - United States expert panel consensus
AU - Elmariah, Sarina
AU - Kim, Brian
AU - Berger, Timothy
AU - Chisolm, Sarah
AU - Kwatra, Shawn G.
AU - Mollanazar, Nicholas
AU - Yosipovitch, Gil
N1 - Publisher Copyright:
© 2020 American Academy of Dermatology, Inc.
PY - 2021/3
Y1 - 2021/3
N2 - Background: Prurigo nodularis (PN) is a chronic disease characterized by intensely pruritic, raised, nodular lesions. Because there are currently no United States Food and Drug Administration-approved therapies specifically for PN, management is highly variable, and no consensus exists on treatment regimens. Objective: To provide practical guidance to help United States dermatologists diagnose and effectively treat patients with PN. Methods: We participated in a roundtable discussion to develop consensus recommendations on diagnosis and treatment of PN from a United States perspective. Results: The core findings in PN are the presence of firm, nodular lesions; pruritus lasting at least 6 weeks; and a history or signs, or both, of repeated scratching, picking, or rubbing. The diagnostic workup involves a complete review of systems, considering potential systemic diseases, and assessment of disease severity, including disease burden and pruritus intensity. Treatment should be selected based on a patient's clinical presentation, comorbidities, and response to prior treatments and should address both neural and immunologic components of pruritus. Limitations: Data on PN are from anecdotal or small clinical trials, and all treatments are currently used off-label. Conclusion: An effective treatment approach for patients with PN should be based on clinical judgment and tailored to the individual needs of the patient.
AB - Background: Prurigo nodularis (PN) is a chronic disease characterized by intensely pruritic, raised, nodular lesions. Because there are currently no United States Food and Drug Administration-approved therapies specifically for PN, management is highly variable, and no consensus exists on treatment regimens. Objective: To provide practical guidance to help United States dermatologists diagnose and effectively treat patients with PN. Methods: We participated in a roundtable discussion to develop consensus recommendations on diagnosis and treatment of PN from a United States perspective. Results: The core findings in PN are the presence of firm, nodular lesions; pruritus lasting at least 6 weeks; and a history or signs, or both, of repeated scratching, picking, or rubbing. The diagnostic workup involves a complete review of systems, considering potential systemic diseases, and assessment of disease severity, including disease burden and pruritus intensity. Treatment should be selected based on a patient's clinical presentation, comorbidities, and response to prior treatments and should address both neural and immunologic components of pruritus. Limitations: Data on PN are from anecdotal or small clinical trials, and all treatments are currently used off-label. Conclusion: An effective treatment approach for patients with PN should be based on clinical judgment and tailored to the individual needs of the patient.
KW - chronic nodular prurigo
KW - diagnosis
KW - prurigo nodularis
KW - pruritus
KW - treatment
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U2 - 10.1016/j.jaad.2020.07.025
DO - 10.1016/j.jaad.2020.07.025
M3 - Review article
C2 - 32682025
AN - SCOPUS:85099154793
SN - 0190-9622
VL - 84
SP - 747
EP - 760
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 3
ER -