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. 2025 Jun 16:105:adv43419.
doi: 10.2340/actadv.v105.43419.

Four Cases of Prurigo Nodularis Requiring Nemolizumab due to Persistent Pruritus or Lesions after Dupilumab Treatment

Yoshihito Mima  1 , Masako Yamamoto  2 , Ken Iozumi  2
Affiliations

Four Cases of Prurigo Nodularis Requiring Nemolizumab due to Persistent Pruritus or Lesions after Dupilumab Treatment

Yoshihito Mima et al. Acta Derm Venereol. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

YM and KI have received lecture fees from Maruho Co., which markets nemolizumab.

Figures

Fig. 1
Fig. 1
Clinical features of Patient 1 with prurigo nodularis who switched to nemolizumab after 12 weeks of dupilumab treatment due to persistent pruritus. (A) Baseline back lesions at the start of nemolizumab treatment. Before nemolizumab, dupilumab had led to partial flattening of the nodules, but numerous palpable lesions remained (PN-IGA 4), and pruritus remained severe (PP-NRS 7). (B) At Week 4, previously palpable nodules showed further flattening and signs of improvement (PN-IGA 3), though pruritus persisted (PP-NRS 5). (C) At Week 12, most nodules had flattened and evolved into post-inflammatory hyperpigmentation (PN-IGA 2), while pruritus remained stable (PP-NRS 6).
Fig. 2
Fig. 2
Clinical features of Patient 3 with prurigo nodularis who switched to nemolizumab after 13 weeks of dupilumab treatment due to persistent pruritus or skin lesions. (A) Baseline back lesions at the start of nemolizumab treatment. Before nemolizumab, despite prior dupilumab treatment, the nodules remained largely unchanged, with numerous palpable lesions (PN-IGA 4), and pruritus was extremely severe (PP-NRS 10). (B) At Week 4, the nodules showed no significant flattening and remained stable (PN-IGA 4), but pruritus improved markedly (PP-NRS 5). (C) At Week 12, some nodules showed signs of shrinkage, but many remained palpable (PN-IGA 4). However, pruritus continued to improve (PP-NRS 3).
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