الحكاك العقيدي (Prurigo Nodularis)

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Prurigo Nodularis

 

(Diseases)

On this page, you will find everything you need to know about Prurigo Nodularis. 

 

What is Prurigo Nodularis?

  • Prurigo Nodularis is a chronic, non-contagious skin condition characterized by the appearance of firm, dry nodules on the skin. These lesions can occur on various parts of the body, such as the arms, legs, and shoulders, and are intensely itchy, significantly affecting sleep quality and mental health. Also known as chronic nodular prurigo, the condition can develop at any age but is more common among older adults. 
  • What are the symptoms of Prurigo Nodularis? 
  • Severe itching: This is the main symptom. It can be constant or intermittent, and may worsen with heat, sweating, and irritant fabrics such as synthetics. 
  • Firm, dry, rough nodules: Ranging in size from pinhead-sized to over 3 cm. These nodules may be skin-colored, pink, red, dark brown, or even black. 
  • Nodule development: They usually start small and red, and over time, become scaly and ulcerated due to scratching. 
  • The affected skin becomes thick, dry, and cracked due to repeated itching. 

 

The bumps and the associated itching may persist for several months or even years without treatment.

Symptoms tend to recur periodically, even during periods of improvement. 

  • The exact cause is unknown, but several risk factors may contribute, including: 
  • Skin allergies, such as eczema. 
  • Systemic diseases like kidney or liver disorders. 
  • Nutritional deficiencies, especially iron deficiency. 
  • Psychological factors such as stress, anxiety, and depression. 
  • Insect bites. 

 

Environmental triggers,like heat and sweating.

Rarely, medications such as chemotherapy may trigger the condition. 

  • How is Prurigo Nodularis diagnosed? 
  • The diagnosis typically involves: 
  • Medical history and clinical examination. 
  • Dermatoscopy: A handheld magnified lighted device used to examine the surface layers of the skin.CBC). 
  • Patch testing: To identify potential allergens. 
  • Skin biopsy: To confirm the diagnosis by revealing histological features such as epidermal thickening,and increased nerve fibers, and neuropeptides associated with itching. 

 

Liver and kidney function tests.

Thyroid function tests. 

  1. 1Screening for infectious diseases such as HIV and Hepatitis C.

What are the treatment options for Prurigo Nodularis? 

  1. 2While there is no universal cure, treatments aim to relieve itching, improve skin appearance, and prevent progression. Options include:
  • 1. Intralesional injections: 
  • Corticosteroids are injected directly into nodules to reduce inflammation, itchiness, pain, and redness. 
  • 2. Topical treatments: 
  • Calamine lotion: A common antihistamine-based lotion for itch relief. 
  1. Topical corticosteroids: To reduce inflammation and itching.
  • Topical vitamin D analogs: To help regulate skin cell growth and inflammation. 
  • Calcineurin inhibitors: Immunosuppressants that calm the immune system ,contributing to the itch. 
  • 3. Other treatment options: 

 

Cryotherapy: Liquid nitrogen is used to freeze large or severely itchy lesions, often combined with corticosteroid injections.

Immunosuppressive medications: For cases related to autoimmune diseases like lupus or psoriasis. 

  • Phototherapy (light therapy): Uses ultraviolet light to reduce itching and promote skin healing by calming immune cells that release histamine. 
  • How can Prurigo Nodularis be prevented? 
  • There’s no guaranteed prevention, but flare-ups and symptom aggravation can be minimized by: 
  • Avoiding direct sun exposure or using SPF 30+ sunscreen. 
  • Keeping nails trimmed to reduce skin damage from scratching. 
  • Avoiding heat and activities that cause sweating. 

 

 

Using gentle cleansers and moisturizers.

Wearing long-sleeved clothing and gloves to protect skin from scratches. 

 

Treating open or bleeding wounds with antibiotic ointment and clean dressings.

What are the complications of Prurigo Nodularis? 

  • It may lead to: 
  • Nodular prurigo can lead to complications, including the development of a pattern of automatic scratching even in the absence of itch sensation, which contributes to worsening the condition. Additionally, itching and repeated scratching may cause infections, leading to skin ulcers and abscess formation.” 
  • When should you see a doctor? 
  • Seek medical attention if you notice any signs of infection, such as: 
  • Discharge or pus. 
  • Fever. 

 

Pain.

swelling around the lesions.

  • Redness or warmth around,affected skin. 
  • Red streaks around the nodules. 
  • Frequently Asked Questions: 
  • Q: What increases the risk of developing Prurigo Nodularis?HIV). 
  • Skin conditions like eczema, psoriasis, and severe dryness. 
  • Chronic diseases: chronic kidney failure, liver disease, cancer, diabetes. 
  • Thyroid disorders. 
  • HIV. 

 

Iron deficiency.

Gout. 

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