Treatment and Burden of Disease in a Cohort of Patients with Prurigo Nodularis: A Survey-based Study
Tanja Todberg, Claus Zachariae, Lone Skov
Prurigo nodularis is a pruritic dermatosis with poor treatment options. To describe treatment patterns, comorbidities, pruritus, and quality of life a survey was administered to 92 patients with prurigo nodularis. A total of 52 patients completed the survey. The most frequently used treatments were topical corticosteroids, which were prescribed to 49/52 patients, with positive effect in 13/49. A total of 46/52 patients were treated with ultraviolet B, and 9/46 reported a positive effect. A positive effect was reported for topical corticosteroids under occlusion in 21/40, for zinc dressing treatment in 17/37, for steroid injection in 9/14, for methotrexate in 5/16, and for thalidomide in 4/12 of treated patients. Thirty-six patients reported a Pittsburgh Sleep Quality Index >5, indicating poor sleep. Patients with prurigo nodularis are severely bothered by pruritus negatively affecting quality of life. Various treatments are prescribed; most frequently topical corticosteroids and ultraviolet B. Surprisingly, patients reported topical corticosteroids under occlusion, zinc-dressing treatment and steroid injection as the most effective.
Prurigo nodularis is a rare skin disease characterized by intense pruritus, leading to lack of sleep and reduced quality of life. For dermatologists worldwide, treatment of prurigo nodularis remains a challenge, as there are no approved treatments for the disease and patients are often insufficiently treated with the existing therapies. This patient-based survey examined treatment tendencies and treatment effectiveness, comorbidities, pruritus and quality of life in a cohort of patients with prurigo nodularis. Overall, topical corticosteroids and ultraviolet B are the most commonly used treatments; however, topical corticosteroids under occlusion, zinc-dressing treatment and steroid injection were reported as the most effective treatments.