Practical approaches for diagnosis and management of prurigo nodularis: United States expert panel consensus.
chronic nodular prurigo
diagnosis
prurigo nodularis
pruritus
treatment
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
01
05
2020
revised:
03
07
2020
accepted:
05
07
2020
pubmed:
19
7
2020
medline:
29
7
2021
entrez:
19
7
2020
Statut:
ppublish
Résumé
Prurigo nodularis (PN) is a chronic disease characterized by intensely pruritic, raised, nodular lesions. Because there are currently no United States Food and Drug Administration-approved therapies specifically for PN, management is highly variable, and no consensus exists on treatment regimens. To provide practical guidance to help United States dermatologists diagnose and effectively treat patients with PN. We participated in a roundtable discussion to develop consensus recommendations on diagnosis and treatment of PN from a United States perspective. The core findings in PN are the presence of firm, nodular lesions; pruritus lasting at least 6 weeks; and a history or signs, or both, of repeated scratching, picking, or rubbing. The diagnostic workup involves a complete review of systems, considering potential systemic diseases, and assessment of disease severity, including disease burden and pruritus intensity. Treatment should be selected based on a patient's clinical presentation, comorbidities, and response to prior treatments and should address both neural and immunologic components of pruritus. Data on PN are from anecdotal or small clinical trials, and all treatments are currently used off-label. An effective treatment approach for patients with PN should be based on clinical judgment and tailored to the individual needs of the patient.
Sections du résumé
BACKGROUND
BACKGROUND
Prurigo nodularis (PN) is a chronic disease characterized by intensely pruritic, raised, nodular lesions. Because there are currently no United States Food and Drug Administration-approved therapies specifically for PN, management is highly variable, and no consensus exists on treatment regimens.
OBJECTIVE
OBJECTIVE
To provide practical guidance to help United States dermatologists diagnose and effectively treat patients with PN.
METHODS
METHODS
We participated in a roundtable discussion to develop consensus recommendations on diagnosis and treatment of PN from a United States perspective.
RESULTS
RESULTS
The core findings in PN are the presence of firm, nodular lesions; pruritus lasting at least 6 weeks; and a history or signs, or both, of repeated scratching, picking, or rubbing. The diagnostic workup involves a complete review of systems, considering potential systemic diseases, and assessment of disease severity, including disease burden and pruritus intensity. Treatment should be selected based on a patient's clinical presentation, comorbidities, and response to prior treatments and should address both neural and immunologic components of pruritus.
LIMITATIONS
CONCLUSIONS
Data on PN are from anecdotal or small clinical trials, and all treatments are currently used off-label.
CONCLUSION
CONCLUSIONS
An effective treatment approach for patients with PN should be based on clinical judgment and tailored to the individual needs of the patient.
Identifiants
pubmed: 32682025
pii: S0190-9622(20)32189-7
doi: 10.1016/j.jaad.2020.07.025
pii:
doi:
Substances chimiques
Dermatologic Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
747-760Subventions
Organisme : NIAMS NIH HHS
ID : K08 AR069753
Pays : United States
Informations de copyright
Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.