%0 Journal Article
%T Practical approaches for diagnosis and management of prurigo nodularis: United States expert panel consensus.
%A Elmariah S
%A Kim B
%A Berger T
%A Chisolm S
%A Kwatra SG
%A Mollanazar N
%A Yosipovitch G
%J J Am Acad Dermatol
%V 84
%N 3
%D Mar 2021
%M 32682025
%F 15.487
%R 10.1016/j.jaad.2020.07.025
%X <B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>To provide practical guidance to help United States dermatologists diagnose and effectively treat patients with PN.<BR><B>METHODS: </B>We participated in a roundtable discussion to develop consensus recommendations on diagnosis and treatment of PN from a United States perspective.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>Data on PN are from anecdotal or small clinical trials, and all treatments are currently used off-label.<BR><B>CONCLUSIONS: </B>An effective treatment approach for patients with PN should be based on clinical judgment and tailored to the individual needs of the patient.