Prurigo Nodularis (PN)

Prurigo means itch, and Nodularis means bump. This is a frustrating condition where patients itch in random spots and the itch drives them to scratch those areas. Over time, the scratched areas thicken and bumps form. It is notoriously difficult to treat and sometimes we have to go through several medicines before we find something that controls the sensation and allows healing to proceed. Sadly, many patients are told that this is a mental problem. This is decidedly not mental. It is a very real sensation and it needs to be treated properly.

We now have several excellent medicines that work very well for patients with this difficult to treat disease. They include:

  • Dupixent injection (only medicine approved for PN)
  • Cyclosporine-A Modified oral
  • Methotrexate oral
  • Gabapentin oral
  • Pregabalin oral
  • Naltrexone oral
  • Aprepitant oral
  • Thalomid (thalidomide oral)
  • Revlimid (lenalidomide oral)
  • Narrow-band Ultraviolet B light therapy
  • Intramuscular Kenalog

It may take trials of several medicines before we find something that helps. Sometimes, although we end up controlling the disease, the bumps and left-over color may not go away. We may have to shave them off under local anesthesia to allow the areas to heal, and we may need to use fading creams like Klaroquin and Retrenix to help improve this color.

As frustrating as this can be, there is usually some way to make it better, so do not give up hope!

Schedule your consultation with Dr. Resnik