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Prurigo nodularis in Adult
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Prurigo nodularis in Adult

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Contributors: Vivian Wong MD, PhD, Lauren Ko, Belinda Tan MD, PhD, Susan Burgin MD
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Synopsis

Prurigo nodularis is a chronic condition of uncertain etiology. Although exact prevalence is unknown, it is most commonly seen in patients 45 years and older and seems to be more common in women. Patients present with one or more (usually multiple) discrete, severely pruritic nodules that mostly appear on the extensor surfaces of extremities and anterior areas of the thighs and legs. The lesions are rarely seen on the face. The lesions are triggered by repetitive rubbing or scratching of discrete areas of the skin. Pruritus is described as severe and distressing and can become worse with heat, sweating, or irritation from friction. It may alternatively be induced by repetitive picking or rubbing of nonpruritic skin.

Prurigo nodularis may be secondary to skin conditions associated with pruritus, such as atopic dermatitis and xerosis, as well as systemic conditions associated with generalized pruritus without a primary skin rash, such as psychiatric conditions, human immunodeficiency virus (HIV) infection, iron-deficiency anemia, diabetes mellitus, gluten enteropathy, renal or hepatic impairment, malignancies, and others. In most cases, the etiology of pruritus is unknown. Studies have suggested that prurigo nodularis may be a form of subclinical small fiber neuropathy and that Th2 cytokines play an important role in pathogenesis.

Lesions are firm dome-shaped, smooth-topped, or crusted nodules. Their size ranges from several millimeters to 1-2 cm, and they often enlarge slowly over time. Lichenification of the lesions is often not present.

Codes

ICD10CM:
L28.1 – Prurigo nodularis

SNOMEDCT:
63501000 – Prurigo nodularis

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The following diagnoses can also mimic the lesions of prurigo nodularis:

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Therapy

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Last Reviewed: 10/19/2018
Last Updated: 10/19/2018
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Prurigo nodularis in Adult
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Prurigo nodularis : Abdomen, Excoriation, Extensor distribution, Lower back, Superior chest, Pruritus, Multiple nodules, Arms, Legs
Clinical image of Prurigo nodularis
A close-up of scaly, pink nodules with central crusts and brown borders.
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