Abstract：
OBJECTIVE: Prurigo nodularis (PN) is a debilitating inflammatory skin disease characterized by red to violaceous pruritic lesions. The goal of therapy is to break the scratch-itch cycle. Treatment varies and often requires a multimodal approach to target both immune and neural mediated aspects of disease.
OBJECTIVE: To review the efficacy of systemic treatment used to treat PN.
METHODS: A systematic search of keywords and Medical Subject Headings was performed in Ovid MEDLINE, Embase, Scopus, and ClinicalTrials.gov. The first 200 results of an abbreviated search in Google Scholar were also included. PRISMA guidelines were followed and the review was registered on PROSPERO (CRD42023412012). GRADE criteria were used to assess articles for quality of evidence.
RESULTS: The search resulted in 1153 articles; 382 were duplicates, 643 were irrelevant, 19 were not retrieved, 21 were abstract only, and 88 are included in this review. There were 24 studies on dupilumab, 16 on thalidomide, 8 on cyclosporin, 7 on methotrexate, 3 each on lenalidomide and aprepitant, 2 each on alitretinoin, apremilast, baricitinib, gabapentin, intravenous (IV) immunoglobulins, pregabalin, tofacitinib, and 1 each on amitriptyline, azathioprine, butorphanol, isoquercitin, IV dexamethasone-cyclophosphamide/ oral cyclophosphamide, ketotifen, metronidazole, montelukast, nalbuphine, nemolizumab, serolopitant, tacrolimus, and herose derma zima capsule.
CONCLUSIONS: Dupilumab reduces pruritus and appearance of lesions and is associated with the fewest number of side effects. Thalidomide and pregabalin are also effective, but their long-term use is limited by muscle and nerve pain. Janus Kinase inhibitors may be beneficial, but large population studies are lacking.
OBJECTIVE: To review the efficacy of systemic treatment used to treat PN.
METHODS: A systematic search of keywords and Medical Subject Headings was performed in Ovid MEDLINE, Embase, Scopus, and ClinicalTrials.gov. The first 200 results of an abbreviated search in Google Scholar were also included. PRISMA guidelines were followed and the review was registered on PROSPERO (CRD42023412012). GRADE criteria were used to assess articles for quality of evidence.
RESULTS: The search resulted in 1153 articles; 382 were duplicates, 643 were irrelevant, 19 were not retrieved, 21 were abstract only, and 88 are included in this review. There were 24 studies on dupilumab, 16 on thalidomide, 8 on cyclosporin, 7 on methotrexate, 3 each on lenalidomide and aprepitant, 2 each on alitretinoin, apremilast, baricitinib, gabapentin, intravenous (IV) immunoglobulins, pregabalin, tofacitinib, and 1 each on amitriptyline, azathioprine, butorphanol, isoquercitin, IV dexamethasone-cyclophosphamide/ oral cyclophosphamide, ketotifen, metronidazole, montelukast, nalbuphine, nemolizumab, serolopitant, tacrolimus, and herose derma zima capsule.
CONCLUSIONS: Dupilumab reduces pruritus and appearance of lesions and is associated with the fewest number of side effects. Thalidomide and pregabalin are also effective, but their long-term use is limited by muscle and nerve pain. Janus Kinase inhibitors may be beneficial, but large population studies are lacking.
摘要：
目的：结节性痒疹（PN）是一种使人衰弱的炎症性皮肤病，以红色至紫罗兰色瘙痒为特征。治疗的目标是打破抓痒周期。治疗各不相同，通常需要多模式方法来靶向免疫和神经介导的疾病方面。
目的：综述全身治疗PN的疗效。
方法：在OvidMEDLINE中对关键词和医学主题词进行了系统搜索，Embase,Scopus,和ClinicalTrials.gov.还包括GoogleScholar中缩写搜索的前200个结果。遵循PRISMA指南，审查在PROSPERO（CRD42023412012）上注册。使用等级标准评估文章的证据质量。
结果：搜索产生了1153篇文章；382个重复，643是无关紧要的，19人没有被找回，21只是抽象的，和88包括在这次审查中。有24项关于dupilumab的研究，16关于沙利度胺，8环孢菌素，7甲氨蝶呤，来那度胺和阿瑞匹坦各3份，阿利维甲酸各2个，apremilast,baricitinib,加巴喷丁,静脉（IV）免疫球蛋白，普瑞巴林,托法替尼,阿米替林各1个，硫唑嘌呤，布托啡诺,isoquercitin,IV地塞米松-环磷酰胺/口服环磷酰胺，酮替芬,甲硝唑,孟鲁司特,纳布啡,奈莫珠单抗,serolopitant,他克莫司,和herosedermazima胶囊。
结论：Dupilumab可减少瘙痒和病变的出现，并与最少数量的副作用相关。沙利度胺和普瑞巴林也有效，但是它们的长期使用受到肌肉和神经疼痛的限制。Janus激酶抑制剂可能是有益的，但是缺乏大量的人口研究。
目的：综述全身治疗PN的疗效。
方法：在OvidMEDLINE中对关键词和医学主题词进行了系统搜索，Embase,Scopus,和ClinicalTrials.gov.还包括GoogleScholar中缩写搜索的前200个结果。遵循PRISMA指南，审查在PROSPERO（CRD42023412012）上注册。使用等级标准评估文章的证据质量。
结果：搜索产生了1153篇文章；382个重复，643是无关紧要的，19人没有被找回，21只是抽象的，和88包括在这次审查中。有24项关于dupilumab的研究，16关于沙利度胺，8环孢菌素，7甲氨蝶呤，来那度胺和阿瑞匹坦各3份，阿利维甲酸各2个，apremilast,baricitinib,加巴喷丁,静脉（IV）免疫球蛋白，普瑞巴林,托法替尼,阿米替林各1个，硫唑嘌呤，布托啡诺,isoquercitin,IV地塞米松-环磷酰胺/口服环磷酰胺，酮替芬,甲硝唑,孟鲁司特,纳布啡,奈莫珠单抗,serolopitant,他克莫司,和herosedermazima胶囊。
结论：Dupilumab可减少瘙痒和病变的出现，并与最少数量的副作用相关。沙利度胺和普瑞巴林也有效，但是它们的长期使用受到肌肉和神经疼痛的限制。Janus激酶抑制剂可能是有益的，但是缺乏大量的人口研究。
