Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 30;100(16):adv00269.
doi: 10.2340/00015555-3571.

Analysis of 325 Patients with Chronic Nodular Prurigo: Clinics, Burden of Disease and Course of Treatment

Sonja Gründel  1 , Manuel P Pereira, Michael Storck, Nani Osada, Gudrun Schneider, Sonja Ständer, Claudia Zeidler
Affiliations

Analysis of 325 Patients with Chronic Nodular Prurigo: Clinics, Burden of Disease and Course of Treatment

Sonja Gründel et al. Acta Derm Venereol. .

Abstract

Chronic nodular prurigo presents with multiple pruriginous nodules and severe pruritus. This study aims to explore the treatment course and regimens in patients with chronic nodular prurigo and to analyse predictive factors contributing to therapeutic success. A total of 325 patients with chronic nodular prurigo (male 37.5%) were analysed concerning demographic data, pruritus intensity, medical history, psychological impairment, quality of life, treatment duration, regimens and outcome. These parameters were compared with 325 sex- and age-matched patients with chronic pruritus on non-lesional skin. Treatment success was dependent on duration and regime of treatment and independent of age, sex and initial itch intensity. Non-responders displayed a higher percentage of inflamed nodules, a higher portion of excoriated nodules and a higher impairment of quality of life and mood factors before initiation of treatment. Gabapentinoids and immunosuppressants proved to be the most successful therapeutic agents. Compared with patients with chronic pruritus, those with chronic nodular prurigo needed longer duration of therapy.

Keywords: anti­pruritic therapy; chronic prurigo; pruritus; treatment; prurigo nodularis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Example of the evaluation of the estimated number of nodules: (a) few, (b) moderate, (c) many.
Fig. 2
Fig. 2
Example of the evaluation of the inflammation of nodules: (a) non-inflamed, (b) inflamed.
Fig. 3
Fig. 3
Example of the evaluation of the proportion of excoriated nodules vs non-excoriated nodules: (a) few, (b) moderate, (c) many.
Fig. 4
Fig. 4
Response to treatment, measured by dynamic pruritus score. CNPG: chronic nodular prurigo; CP: chronic pruritus; NR: non-responders; WR: weak responders; GR: good responders; VGR: very good responders.
Fig. 5
Fig. 5
Comparison of treatment duration between patients with chronic nodular prurigo (CNPG) and chronic pruritus (CP) on non-lesional skin (non-responders (NR) < 30% pruritus improvement; weak responders (WR) 30–49%; good responders (GR) 50–69%; very good responders (VGR) ≥ 70%). Outliers were excluded for better visualization. *p < 0.001.
See this image and copyright information in PMC

References

    1. Pereira MP, Steinke S, Zeidler C, Forner C, Riepe C, Augustin M, et al. . European academy of dermatology and venereology European prurigo project: expert consensus on the definition, classification and terminology of chronic prurigo. J Eur Acad Dermatol Venereol 2018; 32: 1059–1065. - PubMed
    1. Pereira MP, Zeidler C, Nau T, Bobko S, Evers AWM, Garcovich S, et al. . Position Statement: Linear prurigo is a subtype of chronic prurigo. J Eur Acad Dermatol Venereol 2019; 33: 263–266. - PubMed
    1. Zeidler C, Tsianakas A, Pereira M, Ständer H, Yosipovitch G, Ständer S. Chronic prurigo of nodular type: a review. Acta Derm Venereol 2018; 98: 173–179. - PubMed
    1. Weisshaar E, Szepietowski JC, Dalgard FJ, Garcovich S, Gieler U, Giménez-Arnau AM, et al. . European S2k Guideline on Chronic Pruritus. Acta Derm Venereol 2019; 99: 469–506. - PubMed
    1. Ständer S, Kwon P, Hirman J, Perlman AJ, Weisshaar E, Metz M, et al. . Serlopitant reduced pruritus in patients with prurigo nodularis in a phase 2, randomized, placebo-controlled trial. J Am Acad Dermatol 2019; 80: 1395–1402. - PubMed