Prurigo nodularis is a chronic skin disorder with very pruritic skin lesions which can adversely impact a patient's quality of life.

Pathogenesis: uncertain


Clinical features:

(1) multiple firm papules, plaques and nodules

(2) located on the extensor surfaces of the extremities with a symmetrical distribution

(3) flesh-colored to pink to brown or black

(4) very pruritic, either intermittently or continuously

(5) hyperkeratotic

(5) may be concurrent with another skin lesion


Concurrent conditions may include:

(1) chronic renal failure

(2) malignancy

(3) chronic liver disease

(4) HIV infection

(5) gout

(6) parasitic infection

(7) drugs


Pruritic nodules can occur in:

(1) scabies

(2) leprosy

(3) actinic prurigo


Differential diagnosis:

(1) lichen simplex chronicus

(2) hypertrophic lichen planus

(3) pemphigoid nodularis

(4) epidermolysis bullosa

(5) small fiber neuropathy

(6) foreign body reaction

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