Management of Prurigo Nodularis: a review
Abstract Prurigo nodularis is a chronic condition of the skin that presents with highly pruritic inflammatory nodules. It may occur alone, or with other skin & systemic diseases. Persistent itching in prurigo nodularis interfere with daily activities and leads a burden on patents well beings. Disruption of neurologic and immunologic function with upregulation of IL-4, IL-31 and neuropeptides are key factors regarding its pathology. Several topical agents (e.g., local corticosteroid, calcineurin inhibitors, calcipotriene, capsaicin, ketamine) & systemic neuro modulators (e.g., gabapentin, pregabalin, paroxetine, aprepitant, naltrexone) and immune modulators (e.g. Methotrexate, cyclosporine, azathioprine, biologics) have been studies to overcome this distressing condition. In addition, maintenance of skin hydration, stress relief and management of associated condition found promising for sustained response to therapy. Recently FDA has approved dupilumab for prurigo nodularis treatment. Keywords: Prurigo nodularis, Pruritus, neuro modulator, immune modulator. |