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. 2018 Oct;79(4):714-719.e3.
doi: 10.1016/j.jaad.2018.04.047. Epub 2018 May 4.

Ethnic differences and comorbidities of 909 prurigo nodularis patients

Emily Boozalis  1 , Olive Tang  2 , Shivani Patel  1 , Yevgeniy R Semenov  3 , Manuel P Pereira  4 , Sonja Stander  4 , Sewon Kang  1 , Shawn G Kwatra  5
Affiliations

Ethnic differences and comorbidities of 909 prurigo nodularis patients

Emily Boozalis et al. J Am Acad Dermatol. 2018 Oct.

Abstract

Background: Prurigo nodularis (PN) is a poorly understood, understudied pruritic dermatosis that reduces quality of life.

Objective: To characterize the demographics and comorbidities associated with PN.

Methods: Cross-sectional study of patients 18 years and older who were seen at the Johns Hopkins Health System between December 6, 2012, and December 6, 2017.

Results: Over the past 5 years, 909 patients with PN were seen at Johns Hopkins Health System. African American patients were 3.4 times more likely to have PN than white patients were (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.9-3.9; P < .001). A comparison of the study patients and race-matched controls revealed that PN was significantly associated with a variety of systemic, cardiovascular, and psychiatric comorbidities, including chronic kidney disease, chronic hepatitis C, chronic obstructive pulmonary disease, congestive heart failure, depression, and atopic dermatitis. Black patients with PN were 10.5 times more likely (OR, 10.5; 95% CI, 7.9-13.9; P < .001) to have HIV than were race-matched controls with atopic dermatitis, and 8 times more likely (OR, 8.0; 95% CI, 5.7-11.1; P < .001) to have HIV than were African American patients with psoriasis.

Limitations: Our data describe patients seen by 1 hospital system. Our data identify associated conditions and comorbidities but are unable to support a causal relationship.

Conclusion: PN disproportionately affects African Americans and is associated with several systemic conditions, including HIV, chronic kidney disease, and diabetes.

Keywords: HIV; PN; atopic dermatitis; chronic kidney disease; itch; prurigo nodularis; pruritus; psoriasis.

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Figures

Fig 1.
Fig 1.
Racial backgrounds of all patients 18 years and older with a diagnosis of prurigo nodularis (PN), atopic dermatitis (AD), or psoriasis and within the general population who presented to the Johns Hopkins Hospital System over the past 5 years. AA, African American.
Fig 2.
Fig 2.
Age distribution of patients with prurigo nodularis (PN) overall, in African Americans (AAs), and in white patients. Most patients (43%−45%) with PN were between 51 and 65 years old.
Fig 3.
Fig 3.
Percentages of African American patients with prurigo nodularis (PN), atopic dermatitis (AD), or psoriasis and in the general population who are HIV positive. African American patients with PN were 10.5 times more likely to have HIV than were race-matched patients with AD and 8 times more likely to have HIV than were race-matched patients with psoriasis.
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References

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