{Reference Type}: Journal Article
{Title}: Practical approaches for diagnosis and management of prurigo nodularis: United States expert panel consensus.
{Author}: Elmariah S;Kim B;Berger T;Chisolm S;Kwatra SG;Mollanazar N;Yosipovitch G;
{Journal}: J Am Acad Dermatol
{Volume}: 84
{Issue}: 3
{Year}: Mar 2021
{Factor}: 15.487
{DOI}: 10.1016/j.jaad.2020.07.025
{Abstract}: <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.