Prurigo Nodularis: An Uncommon Skin Condition


Does your skin at times feel intensely itchy? It could be an indication of Prurigo Nodularis. It is a rare skin condition with a prevalence rate of 72 per 100,000 people. The itch caused by Prurigo Nodularis is so intense that it disrupts daily life activities, along with physical and mental health. The size of bumps varies from a small to half an inch in diameter. Prurigo Nodularis is difficult to treat. However, various Clinical Research Organizations in the US are trying to find a potential treatment option for Prurigo Nodularis. 

In this blog, we will be focusing on how Prurigo Nodularis affects the skin, what are the causes, and its impact on physical and mental health. 

Site & Appearance of Prurigo Nodularis

Prurigo Nodularis can appear on its own or in association with other skin conditions or underlying diseases that have a significant effect on the body, such as AIDS, cancer, diabetes, or chronic renal disease. Although the actual cause of Prurigo Nodularis is unknown, it is believed that increased itching (pruritus) and frequent scratching are caused by changes in the immune system and cutaneous nerve activity.

Additionally, it is thought that regular skin picking and scratching contribute to the thickness and growth of lesions. Prurigo Nodularis can affect anyone at any age, however, it usually affects the elderly. Prurigo Nodularis is more common in younger persons when it coexists with inflammatory skin disorders, most commonly eczema (also called atopic dermatitis).

Causes Of Prurigo Nodularis

Although the actual cause of Prurigo Nodularis is unknown, it is thought that the condition’s symptoms are brought on by an immunological and neurological system imbalance that is unique to the skin. Patients with Prurigo Nodularis have less epidermal nerve fiber density and more dermal nerve density than individuals without the condition.

Symptoms To Look Out For In Prurigo Nodularis

The Prurigo Nodularis rash, which can differ in appearance from patient to patient, is believed to be the result of excessive, chronic scratching and picking that is caused by intense itching (pruritus), burning, and stinging sensations.

The persistent pruritus that is connected to Prurigo Nodularis lasts for more than six weeks. The majority of the time, it is intense and occurs in bursts, but it can also be ongoing. Sweat, heat, clothing, and stress frequently make it worse.

The amount and severity of lesions can vary from just a few to several hundred, with a width of a half centimeter to two centimeters. The distribution of lesions is frequently symmetrical, and they might be hard dome-shaped papules, plaques, or nodules. Papules, nodules, and plaques in the skin layers vary in breadth and depth. A papule is a raised lesion that is elevated above the skin’s surface and has a diameter of less than 1 cm. A plaque is an elevated lesion with a diameter of more than 1 cm that is wider than it is deep, whereas a nodule is an elevated lesion with a diameter of more than 1 cm that extends into the dermis (the skin layer beneath the epidermis).

In addition to flesh, lesions might be flesh, pink, red, brown, or black. Lesions could become complicated if bacteria spread to them. After lesions have healed, scars and stains could still be present. The upper and lower back, the abdomen, the arms, the back of the head, and the upper and lower legs are commonly affected. The middle back is often lesion-free because it is difficult to scratch and thus less likely to acquire lesions.

Lesions rarely disappear on their own without treatment, thus Prurigo Nodularis symptoms must be treated.

Other Related Skin Disorders

Usually, Prurigo Nodularis is identified based on its clinical signs. Prurigo Nodularis can be mistaken for other skin disorders and can co-occur with some of them because of this and symptom overlap with other ailments that produce severe, chronic pruritus. These consist of:

Bullous Pemphigoid: is a rare kind of autoimmune illness, it is a type where fluid-filled blisters develop on the skin of the arms and legs, mainly in the elderly. Pemphigoid Nodularis, in contrast to Prurigo Nodularis, may disappear on its own after several months to years.

Actinic Prurigo: is a skin condition, which predominantly affects females, causes itchy papules and nodules to form after sun exposure, generally on the upper extremities, face, and neck. Usually, it starts in the spring and lasts all the way through the winter.

Epidermolysis Bullosa: is a genetic skin condition that typically manifests in childhood, and is clinically defined by the production of blisters as a result of friction or mechanical stress to the skin.

Lichen Simplex Chronicus: also called Neurodermatitis, is a common form of eczema that affects one to two patches of skin and gets worse when scratched.

Lichen Amyloidosis: is a condition in which papules develop on the shins and forearms in lichen amyloidosis, a form of primary localized cutaneous amyloidosis caused by aberrant protein deposits in the skin brought on by a change in protein metabolism.

Treatment Options

The standard of care for Prurigo Nodularis includes both behavioral and pharmaceutical treatments. Although many medications used to treat other skin conditions or immune system problems are also used to treat Prurigo Nodularis, there is currently no FDA-approved treatment for Prurigo Nodularis.

Behavioral Therapy

Some behavioral treatments for Prurigo Nodularis that help to stop scratching and dryness include wearing long sleeves and gloves, bandaging lesions, using gentle cleansers to wipe the skin, using non-irritating lotions to keep the skin moisturized, and avoiding hot environments. Typically, anti-itch lotions are used to reduce the impulse to scratch.

If first-line therapies are unsuccessful, further treatments include immunosuppressive medications, cryotherapy, and phototherapy.

When No Other Treatment Works

Cryotherapy is regarded as an alternative kind of medicine. The skin is subjected to freezing or almost freezing temperatures to enhance the appearance of lesions and reduce itching. Phototherapy uses UVA and/or UVB radiation to hasten healing and reduce irritation. It is believed to work by reducing levels of substance P, histamine, and the peptide produced by inflammatory cells and connected to the calcitonin gene.

Since they have the potential to have more severe side effects and harm more body systems, immunosuppressants are only used in the most severe cases of Prurigo Nodularis.


Prurigo Nodularis (PN), an excruciatingly itching skin condition, can be crippling. The exact etiology is unknown, however, it is perceived to be connected to a number of other disorders.

Despite the many treatments available, it could take some time to completely control your Prurigo Nodularis symptoms. A combination of topical, pharmacological, and other therapies may likely be helpful for you.

The good news is that many cutting-edge drugs and treatments are being created and tried out. As scientists learn more about the Prurigo Nodularis process, more intricate, effective medications will be developed.

Learn more about Prurigo Nodularis Clinical Trials in Michigan to better understand this uncommon condition and its treatment.