INDIVIDUAL ARTICLE: Management of Prurigo Nodularis

Area of Science:

• Dermatology and immunology
• Neuroscience
• Pharmacology

Background:

• Prurigo nodularis (PN) is a chronic skin disease causing intense itch and nodules, significantly impacting quality of life.
• Historically, limited FDA-approved treatments existed, with variable management strategies and a lack of formal US guidelines.
• Dupilumab's 2022 FDA approval marked a significant advancement, with novel agents targeting neuroimmune mechanisms under development.

Approach:

• A comprehensive review of PN management was conducted using major biomedical databases (PubMed, Embase, Web of Science, Cochrane Library).
• Clinical trial data from ClinicalTrials.gov, ICH-GCP, and EudraCT databases were also incorporated.
• The review focused on current treatments and emerging therapies for effective patient management.

Key Points:

• PN management requires assessing disease severity, itch intensity, and comorbidities.
• Treatment goals include itch resolution, lesion improvement, and enhanced quality of life.
• Therapies should address both neural and immunologic aspects, with combination therapy potentially beneficial.

Conclusions:

• Conventional PN treatment data are often limited to anecdotal reports or small trials.
• No head-to-head comparative trials exist for conventional, emerging, or combination therapies.
• The PN treatment landscape is rapidly evolving, with new agents showing promise.