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Clinical Report

Analysis of 325 Patients with Chronic Nodular Prurigo: Clinics, Burden of Disease and Course of Treatment

Sonja Gründel, Manuel P. Pereira, Michael Storck, Nani Osada, Gudrun Schneider, Sonja Ständer, Claudia Zeidler
DOI: 10.2340/00015555-3571

Preview of fully accepted paper, still not published in any volume

Abstract

Chronic nodular prurigo presents with multiple pruriginous nodules and severe pruritus. This study aims to explore the treatment course and regimens in patients with chronic nodular prurigo and to analyse predictive factors contributing to therapeutic success. A total of 325 patients with chronic nodular prurigo (male 37.5%) were analysed concerning demographic data, pruritus intensity, medical history, psychological impairment, quality of life, treatment duration, regimens and outcome. These parameters were compared with 325 sex- and age-matched patients with chronic pruritus on non-lesional skin. Treatment success was dependent on duration and regime of treatment and independent of age, sex and initial itch intensity. Non-responders displayed a higher percentage of inflamed nodules, a higher portion of excoriated nodules and a higher impairment of quality of life and mood factors before initiation of treatment. Gabapentinoids and immunosuppressants proved to be the most successful therapeutic agents. Compared with patients with chronic pruritus, those with chronic nodular prurigo needed longer duration of therapy.

Significance

Chronic nodular prurigo is an illness characterized by multiple nodules and severe itch (pruritus). The Center for Chronic Pruritus at the University Hospital Münster analyzed data of 325 patients with chronic nodular prurigo and compared them to patients with chronic pruritus on non-lesional skin. In this sample inflamed and excoriated nodules as well as a low quality of life at beginning of treatment were negative predictors for patient outcome. Chronic nodular prurigo patients suffer from higher itch intensity, depression and impairment of quality of life than patients with chronic prurigo on non-lesional skin. Treatment of chronic nodular prurigo is difficult and can take years, but medications like gabapentinoids and immunosupressants could be beneficial.

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