PRURITUS RESOURCES
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      • Numerical Rating Scale
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    • European Prurigo Project >
      • Pereira et al. J Eur Acad Dermatol Venerol 2022
      • Pereira et al. Acta Derm Venerol 2021
      • Reverte et. al. Ann dermatol Venereol 2020
      • Pereira et al. J Eur Dermatol Venereol 2020
      • Pereira et al. Acta Derm Venereol 2020
      • Pereira et al. ITch 2019
      • Pereira et al. Exp dermatol 2019
      • Pereira et al. curr opin pharmacol 2019
      • Verweyen et al. Acta Derm Venereol 2019
      • Pereira et al. j eur acad dermatol venereol 2019
      • Pereira et al. expert opin investig drugs 2018
      • Pölking et al. J eur acad dermatol venereol 2018
      • Pereira et al. Hautarzt 2018
      • Pereira et al. j eur acad dermatol venerol 2018
      • Pereira et al. j eur acad dermatol venereol 2018
      • Zeidler et al. acta derm venereol 2018
      • Pereira et al. acta derm venereol 2018
      • Pereira et al. itch 2017
      • Pereira et al. drugs 2017
    • Definition of Severity and Descriptors of Chronic Prurigo – Harmonization of European Prurigo Documentation
  • Contact
  • Disclaimer
  • Home
  • 9. Pruritussymposium
    • Information
    • Anmeldung
    • Impressionen
  • Prurigo Nodularis League
  • Chronic Prurigo Guideline
  • Measuring Instruments
    • Itch Intensity >
      • Numerical Rating Scale
      • Visual Analogue Scale
      • Verbal Rating Scale
    • Quality of Life >
      • ItchyQoL
      • DLQI
    • Course of Itch >
      • ItchApp
      • ItchyApp
      • 5-D Itch Scale
      • Itch Controlled Days
      • Dynamic Pruritus Score
      • Patient Benefit Index- Pruritus
    • Deutscher Pruritusfragebogen
  • Task Force Pruritus
    • European Prurigo Project >
      • Pereira et al. J Eur Acad Dermatol Venerol 2022
      • Pereira et al. Acta Derm Venerol 2021
      • Reverte et. al. Ann dermatol Venereol 2020
      • Pereira et al. J Eur Dermatol Venereol 2020
      • Pereira et al. Acta Derm Venereol 2020
      • Pereira et al. ITch 2019
      • Pereira et al. Exp dermatol 2019
      • Pereira et al. curr opin pharmacol 2019
      • Verweyen et al. Acta Derm Venereol 2019
      • Pereira et al. j eur acad dermatol venereol 2019
      • Pereira et al. expert opin investig drugs 2018
      • Pölking et al. J eur acad dermatol venereol 2018
      • Pereira et al. Hautarzt 2018
      • Pereira et al. j eur acad dermatol venerol 2018
      • Pereira et al. j eur acad dermatol venereol 2018
      • Zeidler et al. acta derm venereol 2018
      • Pereira et al. acta derm venereol 2018
      • Pereira et al. itch 2017
      • Pereira et al. drugs 2017
    • Definition of Severity and Descriptors of Chronic Prurigo – Harmonization of European Prurigo Documentation
  • Contact
  • Disclaimer
PRURITUS RESOURCES

INformation for specialists​​

PRURIGO NODULARIS
Bild
rurigo nodularis (PN) begins due to chronic pruritus. This entity presents a great diagnostic and therapeutic challenge. As a result, the affected patients often have a remarkable story to tell about their illness.
Many questions about the pathogenesis of PN have yet to be answered, but current findings and studies provide hope that a better understanding of this disease will be within reach in the not so distant future.

PRIMARY DERMATOSES CARRYING THE NAME “PRURIGO”
  • Prurigo pigmentosa
  • Prurigo actinica
  • Prurigo simplex acuta
  • Prurigo simplex subacuta
Prurigo nodularis should be distinguished from among these and labeled as a secondary reaction pattern characteristic to chronic pruritus and permanent scratching. It can also be considered the maximal variant of the symptom, due partially to its difficult therapy management.

CLINICAL DEFINITION AND CLASSIFICATION
CLINICAL HISTORY OF PRURIGO NODULARIS
Prurigo nodularis was first described in 1909 by J.N. Hyde. The term “prurigo” has since been associated with pruritus and even primary dermatoses, and remains in use today in modern dermatological nomenclature, also for primary dermatoses. For this reason, there is no current single standard use of the term and a lack of clinical delineation of the various diseases designated “prurigo”. The term “prurigo” is used in connection with scratch-induced skin lesions as well as primary dermatoses.
Prurigo nodularis has begun receiving more attention from the global scientific community and clinical examinations are currently underway. Nevertheless, knowledge of prurigo nodularis, its effects and the scientific community’s understanding of it remain insufficient.  Studies have shown in the past that cutaneous neuronal and immune mechanisms play a role. An increased quantity of mast cells, T cells and eosinophil granulocytes seem to be present in the skin, provoking an increased discharge of nerve growth factor (NGF). This is linked with a neuronal hyperplasia of sensory nerve fibers that are involved with the genesis of pruritus.
Many etiological and pathogenetic aspects of PN remain unclear, but it always appears in the form of itchy papules or nodules. Prurigo nodularis is always a result of chronic itch and:

  • the strongest itch sensations
  • considerable psychological strain
  • intense scratching
  • therapy refractory nodules formed as a result of scratching
  • isolated, raised nodules or papules that are often symmetrically arranged
A multitude of dermatoses and systemic diseases resulting in prurigo nodularis include:
  • Atopic dermatitis
  • Bullous pemphigoid
  • Chronic renal failure
  • Hematological diseases
  • Neurological diseases
  • HIV