Abstract：
OBJECTIVE: Chronic nodular prurigo (CNPG) is a recently defined and currently underdiagnosed disease with a variety of causes. It is associated with multiple comorbidities, and its management and treatment have improved with a better understanding of its pathogenesis. The aim of this study was to describe our experience with a series of patients with CNPG.
METHODS: Single-center, observational, retrospective study of the sociodemographic and clinical characteristics of patients with CNPG seen at the dermatology department of a tertiary care hospital between 2009 and 2021.
RESULTS: We included 74 patients, mostly women (63.5%), with a mean age of 57 years. Overall, 39.2% of patients had a concomitant skin condition, mainly atopic dermatitis (62%). Other comorbidities included endocrine disorders (54.1%), cardiovascular disease (44.4%), and psychiatric disorders (36.5%). Skin biopsy helped confirm the clinical diagnosis in 70% of cases. The mean immunoglobulin E level was higher than normal (516 IU/mL), regardless of atopic predisposition. On average, patients received 3 treatments, the most common choices being methotrexate, antihistamines, and topical and oral corticosteroids. Methotrexate was among the most effective options.
CONCLUSIONS: CNPG is a complex disease associated with multiple comorbidities. It requires a multidisciplinary approach, with the dermatologist at the center. Classical treatment approaches are probably insufficient.
METHODS: Single-center, observational, retrospective study of the sociodemographic and clinical characteristics of patients with CNPG seen at the dermatology department of a tertiary care hospital between 2009 and 2021.
RESULTS: We included 74 patients, mostly women (63.5%), with a mean age of 57 years. Overall, 39.2% of patients had a concomitant skin condition, mainly atopic dermatitis (62%). Other comorbidities included endocrine disorders (54.1%), cardiovascular disease (44.4%), and psychiatric disorders (36.5%). Skin biopsy helped confirm the clinical diagnosis in 70% of cases. The mean immunoglobulin E level was higher than normal (516 IU/mL), regardless of atopic predisposition. On average, patients received 3 treatments, the most common choices being methotrexate, antihistamines, and topical and oral corticosteroids. Methotrexate was among the most effective options.
CONCLUSIONS: CNPG is a complex disease associated with multiple comorbidities. It requires a multidisciplinary approach, with the dermatologist at the center. Classical treatment approaches are probably insufficient.
摘要：
目的：慢性结节性痒疹（CNPG）是一种最新定义且目前未被诊断的疾病，具有多种原因。它与多种合并症有关，随着对其发病机制的进一步了解，其管理和治疗有所改善。这项研究的目的是描述我们对一系列CNPG患者的经历。
方法：单中心，观察,回顾性研究2009年至2021年在三级医院皮肤科就诊的CNPG患者的社会人口统计学和临床特征。
结果：我们纳入了74例患者，主要是女性（63.5%），平均年龄57岁.总的来说,39.2%的患者有合并的皮肤状况，主要是特应性皮炎（62%）。其他合并症包括内分泌失调(54.1%)，心血管疾病（44.4%），和精神疾病(36.5%)。在70％的病例中，皮肤活检有助于确认临床诊断。平均免疫球蛋白E水平高于正常值（516IU/mL），不管特应性易感性。平均而言,患者接受了3种治疗，最常见的选择是甲氨蝶呤，抗组胺药,以及局部和口服皮质类固醇。甲氨蝶呤是最有效的选择之一。
结论：CNPG是一种与多种合并症相关的复杂疾病。这需要多学科的方法，中心的皮肤科医生.传统的治疗方法可能是不够的。
方法：单中心，观察,回顾性研究2009年至2021年在三级医院皮肤科就诊的CNPG患者的社会人口统计学和临床特征。
结果：我们纳入了74例患者，主要是女性（63.5%），平均年龄57岁.总的来说,39.2%的患者有合并的皮肤状况，主要是特应性皮炎（62%）。其他合并症包括内分泌失调(54.1%)，心血管疾病（44.4%），和精神疾病(36.5%)。在70％的病例中，皮肤活检有助于确认临床诊断。平均免疫球蛋白E水平高于正常值（516IU/mL），不管特应性易感性。平均而言,患者接受了3种治疗，最常见的选择是甲氨蝶呤，抗组胺药,以及局部和口服皮质类固醇。甲氨蝶呤是最有效的选择之一。
结论：CNPG是一种与多种合并症相关的复杂疾病。这需要多学科的方法，中心的皮肤科医生.传统的治疗方法可能是不够的。
