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Prurigo nodularis (PN) can mimic other serious conditions. Careful diagnosis is crucial, as misdiagnosis can delay treatment for underlying diseases like lymphoma or cancer.

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Area of Science:

  • Dermatology
  • Oncology
  • Psychiatry

Background:

  • Prurigo nodularis (PN) presents as chronic, nodular skin lesions.
  • Accurate diagnosis is essential, requiring consideration of differential diagnoses and PN imitators.

Purpose of the Study:

  • To highlight the importance of reassessing PN diagnosis.
  • To discuss potential misdiagnoses and their consequences.

Main Methods:

  • Case report of five patients with severe chronic pruritus and PN-like lesions.
  • Review of differential diagnoses for prurigo nodularis.

Main Results:

  • Five patients initially diagnosed with PN were found to have other conditions: nodular marginal zone lymphoma, delusional parasitosis, squamous cell carcinomas, and pemphigus foliaceus.
  • Cognitive biases can impede accurate diagnosis.

Conclusions:

  • Reassessment of PN diagnosis is critical to avoid cognitive biases.
  • Timely and accurate diagnosis prevents delayed treatment and improves patient outcomes.