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Abstract：
BACKGROUND: Prurigo nodularis (PN) is a chronic disease characterized by intensely pruritic, raised, nodular lesions. Because there are currently no United States Food and Drug Administration-approved therapies specifically for PN, management is highly variable, and no consensus exists on treatment regimens.
OBJECTIVE: To provide practical guidance to help United States dermatologists diagnose and effectively treat patients with PN.
METHODS: We participated in a roundtable discussion to develop consensus recommendations on diagnosis and treatment of PN from a United States perspective.
RESULTS: The core findings in PN are the presence of firm, nodular lesions; pruritus lasting at least 6 weeks; and a history or signs, or both, of repeated scratching, picking, or rubbing. The diagnostic workup involves a complete review of systems, considering potential systemic diseases, and assessment of disease severity, including disease burden and pruritus intensity. Treatment should be selected based on a patient\'s clinical presentation, comorbidities, and response to prior treatments and should address both neural and immunologic components of pruritus.
CONCLUSIONS: Data on PN are from anecdotal or small clinical trials, and all treatments are currently used off-label.
CONCLUSIONS: An effective treatment approach for patients with PN should be based on clinical judgment and tailored to the individual needs of the patient.
OBJECTIVE: To provide practical guidance to help United States dermatologists diagnose and effectively treat patients with PN.
METHODS: We participated in a roundtable discussion to develop consensus recommendations on diagnosis and treatment of PN from a United States perspective.
RESULTS: The core findings in PN are the presence of firm, nodular lesions; pruritus lasting at least 6 weeks; and a history or signs, or both, of repeated scratching, picking, or rubbing. The diagnostic workup involves a complete review of systems, considering potential systemic diseases, and assessment of disease severity, including disease burden and pruritus intensity. Treatment should be selected based on a patient\'s clinical presentation, comorbidities, and response to prior treatments and should address both neural and immunologic components of pruritus.
CONCLUSIONS: Data on PN are from anecdotal or small clinical trials, and all treatments are currently used off-label.
CONCLUSIONS: An effective treatment approach for patients with PN should be based on clinical judgment and tailored to the individual needs of the patient.
摘要：
背景：结节性痒疹（PN）是一种以强烈瘙痒为特征的慢性疾病，举起,结节性病变.因为目前没有美国食品和药物管理局批准的专门针对PN的疗法，管理是高度可变的，对治疗方案没有共识。
目的：为帮助美国皮肤科医生诊断和有效治疗PN提供实践指导。
方法：我们参加了一次圆桌讨论，从美国的角度就PN的诊断和治疗提出了共识建议。
结果：PN的核心发现是公司的存在，结节性病变;瘙痒持续至少6周;和病史或体征,或者两者兼而有之,反复抓挠，采摘,或摩擦。诊断工作包括对系统进行全面审查，考虑到潜在的全身性疾病，和疾病严重程度的评估，包括疾病负担和瘙痒强度。应根据患者的临床表现选择治疗方法，合并症,和对先前治疗的反应，并应解决瘙痒的神经和免疫成分。
结论：有关PN的数据来自轶事或小型临床试验，目前所有的治疗都是标签外使用的。
结论：PN患者的有效治疗方法应基于临床判断，并根据患者的个人需求量身定制。
目的：为帮助美国皮肤科医生诊断和有效治疗PN提供实践指导。
方法：我们参加了一次圆桌讨论，从美国的角度就PN的诊断和治疗提出了共识建议。
结果：PN的核心发现是公司的存在，结节性病变;瘙痒持续至少6周;和病史或体征,或者两者兼而有之,反复抓挠，采摘,或摩擦。诊断工作包括对系统进行全面审查，考虑到潜在的全身性疾病，和疾病严重程度的评估，包括疾病负担和瘙痒强度。应根据患者的临床表现选择治疗方法，合并症,和对先前治疗的反应，并应解决瘙痒的神经和免疫成分。
结论：有关PN的数据来自轶事或小型临床试验，目前所有的治疗都是标签外使用的。
结论：PN患者的有效治疗方法应基于临床判断，并根据患者的个人需求量身定制。
