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。
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.