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Prurigo Nodularis

Causes 

Prurigo nodularis is a chronic skin condition characterized by intensely itchy nodules or bumps on the skin. The exact cause of prurigo nodularis is unknown, but several factors may contribute:

  • Eczema, psoriasis, or dermatitis can cause chronic scratching and rubbing of the skin.

  • There are several neurological conditions that cause itching sensations, such as nerve damage and neuropathic disorders.

  • Itching and scratching behaviors can be aggravated by psychological factors such as stress, anxiety, or depression.

  • There may be a genetic predisposition, as prurigo nodularis runs in families.

Symptoms

The most common symptom of Prurigo nodularis is the presence of small, hard, itchy bumps or nodules on the skin. These nodules are normally located on the arms, legs, back, or torso. Other symptoms include:

  • Itching that becomes more intense at night or when sweating.

  • Repetitive scratching can result in secondary skin changes such as excoriation (scratch marks), scarring, or hyperpigmentation.

  • If the nodules become inflamed or infected, there may be pain or tenderness at the site.

Diagnosis 

Prurigo nodularis is typically diagnosed by:

  • Assessment of the appearance and distribution of nodules on the skin.

  • Evaluation of symptoms, possible triggers, and underlying conditions that may contribute to prurigo nodularis.

  • To confirm the diagnosis and rule out other skin conditions with similar symptoms, a skin biopsy is performed.

  • Tests to determine whether liver or kidney dysfunction may be associated with prurigo nodularis.

Treatment 

There are several treatment options available for prurigo nodularis, including:

  • Reduce inflammation and itching with topical corticosteroids or calcineurin inhibitors.

  • Antihistamines are used to alleviate itching and improve sleep.

  • Secondary bacterial infections can be treated with topical or oral antibiotics.

  • Inflammation and itching can be reduced with phototherapy (light therapy).

  • Controlling itching and neuropathic pain with oral medications such as gabapentin, pregabalin, or tricyclic antidepressants.

  • Prurigo nodularis can be treated with psychological interventions such as cognitive-behavioral therapy or stress management techniques.

Prevention 

Prurigo nodularis can be prevented by:

  • Itching and scratching behaviors can be exacerbated by irritants or allergens.

  • Maintaining good skincare habits, such as moisturizing regularly and avoiding harsh soaps and detergents.

  • Treating and managing underlying skin conditions or systemic diseases that may contribute to prurigo nodularis.

  • In order to prevent complications such as infection or scarring, seek medical attention as soon as possible if symptoms persist or worsen.

 

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