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Nodular prurigo

Claudia Zeidler, Athanasios Tsianakas, Manuel Pereira, Hartmut Ständer, Gil Yosipovitch, Sonja Ständer
Prurigo nodularis (PN) is a subtype of chronic prurigo presenting single to multiple symmetrically distributed, hyperkeratotic and intensively itching papules and nodules. PN evolves along with chronic pruritus in the context of diverse dermatological, systemic, neurological or psychiatric conditions. Permanent scratching is possibly a major trigger of PN, although its exact pathophysiology remains unclear. Current state-of-the-art therapy for PN consists of topical steroids, capsaicin, calcineurin inhibitors, ultraviolet (UV) therapy, systemic administration of gabapentinoids, μ-opioid receptor antagonists, antidepressants or immunosuppressants...
February 7, 2018: Acta Dermato-venereologica
M P Pereira, S Steinke, C Zeidler, C Forner, C Riepe, M Augustin, S Bobko, F Dalgard, J Elberling, S Garcovich, U Gieler, M Gonçalo, J A Halvorsen, T A Leslie, M Metz, A Reich, E Şavk, G Schneider, E Serra-Baldrich, H F Ständer, M Streit, J Wallengren, K Weller, A Wollenberg, P Bruland, I Soto-Rey, M Storck, M Dugas, E Weisshaar, J C Szepietowski, F J Legat, S Ständer
BACKGROUND: The term prurigo has been used for many decades in dermatology without clear definition, and currently used terminology of prurigo is inconsistent and confusing. Especially, itch-related prurigo remains unexplored regarding the epidemiology, clinical profile, natural course, underlying causes, available treatments and economic burden, although burdensome and difficult to treat. OBJECTIVE: To address these issues, the multicentre European Prurigo Project (EPP) was designed to increase knowledge on chronic prurigo (CPG)...
August 31, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
Enzo Errichetti, Giuseppe Stinco
Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides and subacute cutaneous lupus erythematosus), papulosquamous/papulokeratotic dermatoses (lichen planus, pityriasis rosea, papulosquamous sarcoidosis, guttate psoriasis, pityriasis lichenoides chronica, classical pityriasis rubra pilaris, porokeratosis, lymphomatoid papulosis, papulosquamous chronic GVHD, parakeratosis variegata, Grover disease, Darier disease and BRAF-inhibitor-induced acantholytic dyskeratosis), facial inflammatory skin diseases (rosacea, seborrheic dermatitis, discoid lupus erythematosus, sarcoidosis, cutaneous leishmaniasis, lupus vulgaris, granuloma faciale and demodicidosis), acquired keratodermas (chronic hand eczema, palmar psoriasis, keratoderma due to mycosis fungoides, keratoderma resulting from pityriasis rubra pilaris, tinea manuum, palmar lichen planus and aquagenic palmar keratoderma), sclero-atrophic dermatoses (necrobiosis lipoidica, morphea and cutaneous lichen sclerosus), hypopigmented macular diseases (extragenital guttate lichen sclerosus, achromic pityriasis versicolor, guttate vitiligo, idiopathic guttate hypomelanosis, progressive macular hypomelanosis and postinflammatory hypopigmentations), hyperpigmented maculopapular diseases (pityriasis versicolor, lichen planus pigmentosus, Gougerot-Carteaud syndrome, Dowling-Degos disease, erythema ab igne, macular amyloidosis, lichen amyloidosus, friction melanosis, terra firma-forme dermatosis, urticaria pigmentosa and telangiectasia macularis eruptiva perstans), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), erythrodermas (due to psoriasis, atopic dermatitis, mycosis fungoides, pityriasis rubra pilaris and scabies), noninfectious balanitis (Zoon's plasma cell balanitis, psoriatic balanitis, seborrheic dermatitis and non-specific balanitis) and erythroplasia of Queyrat, inflammatory cicatricial alopecias (scalp discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia and folliculitis decalvans), nonscarring alopecias (alopecia areata, trichotillomania, androgenetic alopecia and telogen effluvium) and scaling disorders of the scalp (tinea capitis, scalp psoriasis, seborrheic dermatitis and pityriasis amiantacea)...
December 2016: Dermatology and Therapy
Björn Dangel, Lukas Kofler, Gisela Metzler
INTRODUCTION: Itching nodules and papules are common findings. A rare but important differential diagnosis is the nodular subtype of bullous pemphigoid. METHODS AND RESULTS: The investigators report a female patient presenting with strongly itching papules disseminated over her extremities and trunk. Physical examination revealed multiple erythematous, mostly excoriated papules and nodules on her back, abdomen, and extremities. Histology showed changes compatible with prurigo lesion, and immunofluorescence showed positive results for BP180 and BP230...
November 2016: Journal of Cutaneous Medicine and Surgery
E Errichetti, G Stinco
Beside to traditional use, dermoscopy is more and more used in the assessment of other "general" dermatologic conditions, namely scalp and hair disorders (trichoscopy), nails abnormalities (onychoscopy), skin infections and infestations (entomodermoscopy), and cutaneous inflammatory diseases (inflammoscopy). Among the list of new applications of dermoscopy, the study of inflammatory dermatoses is probably the most promising topic in terms of development and usefulness, considering the large number of such disorders and the frequent problems in their differential diagnosis which the dermatologist encounters in own daily clinical practice...
October 2015: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
J B Powell, J E Gach
BACKGROUND: Elderly patients present with a unique spectrum of dermatoses that pose particular management opportunities and challenges, which will be increasingly encountered in dermatological practice. The skin of elderly patients differs from that of younger patients not only in appearance but also in structure, physiology and response to ultraviolet (UV) radiation. However, little is known about the safety and efficacy of phototherapy in elderly patients and how phototherapy is currently being utilized to treat them...
August 2015: Clinical and Experimental Dermatology
Enzo Errichetti, Angelo Piccirillo, Giuseppe Stinco
The diagnosis of prurigo nodularis is mainly clinical, based on its distinctive features. However, in some cases it may be difficult to differentiate it from other nodular dermatoses only on the clinical basis, thus requiring histopathological examination to reach a definitive diagnosis. The aim of this study was to describe for the first time the dermoscopic features of prurigo nodularis and the useful contribution of dermoscopy in the differential diagnosis of such dermatoses. Fourteen patients with histopathologically proven prurigo nodularis were included in the study...
June 2015: Journal of Dermatology
G Schneider, J Hockmann, A Stumpf
BACKGROUND/OBJECTIVES: This article gives an overview of the theoretical background and the empirical research concerning psychosomatic aspects of prurigo nodularis (PN). MATERIALS AND METHODS: Literature research in PubMed with the search terms "prurigo nodularis", "nodular prurigo", "psych*"; clinical experience and research of the authors. RESULTS: Although reviews on PN frequently mention psychosomatic aspects, there is little empirical research concerning the subject...
August 2014: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
H H Akar, F Tahan, S Balkanli, S Sadet Özcan
Prurigo is a condition of nodular cutaneous lesions that itch intensely. Prurigo lesions are divided into acute, subacute and chronic forms that itch intensely. Subacute prurigo (SP) clinically presents as excoriated papules mostly in a symmetrical distribution on the extensor surfaces of the extremities, neck, lower trunk, and buttocks. It tends to occur in middle-aged patients, especially in women. Herein, we described prurigo simplex subacuta in a 4-year-old boy. It was histopathologically documented.
July 2014: European Annals of Allergy and Clinical Immunology
Natalia Ossowska-Kreft, Anna Kacalak-Rzepka, Magdalena Kiedrowicz, Romuald Maleszka
The case of a 62-year-old female patient diagnosed with an extremely rare clinical variant of pemphigoid--nodular pemphigoid, imitating prurigo nodularis, is presented in the paper. In connection with the existence of the typical prurigo nodularis-like appearance in the patient, the diagnosis was maintained for several months. However, because of no response to the treatment and the remarkably chronic course of the disease, the patient was admitted to the Department in order to extend the diagnostics and verify the previous diagnosis...
2013: Annales Academiae Medicae Stetinensis
Hui Li Kwong, Su-Ping Regina Lim
No abstract text is available yet for this article.
February 2015: Acta Dermato-venereologica
P Spring, I Gschwind, M Gilliet
BACKGROUND: Prurigo nodularis (PN), or nodular prurigo, is a chronic, debilitating, inflammatory skin disease. It can be very difficult to manage, and represents a challenge for the physician. Methotrexate (MTX) is a safe folic acid antagonist widely used in the management of inflammatory skin diseases such as psoriasis. Weekly administration of 7.5-20 mg methotrexate (low-dose methotrexate, LD-MTX) represents an attractive treatment option, and could therefore find a place in the management of PN...
June 2014: Clinical and Experimental Dermatology
C Albarrán-Planelles, D Jiménez-Gallo, M Linares-Barrios, A Martínez-Rodríguez
A wide range of treatments are currently available for severe atopic dermatitis, including systemic therapies such as ciclosporin, corticosteroids, azathioprine, methotrexate, mofetil mycophenolate, and omalizumab. In patients who can no longer take systemic drugs or who need a dose reduction, wet-wrap treatment can be an excellent option. To date, wet wraps have mostly been used in severe cases of childhood atopic dermatitis. We report our experience with wet-wrap treatment in 5 adults with atopic dermatitis and 2 with nodular prurigo...
April 2014: Actas Dermo-sifiliográficas
Varadraj Vasant Pai, Tukaram Sori, Kikkeri Narayanshetty Naveen, Sharatchandra Bhimrao Athanikar, Vijetha Rai, Dinesh Udupi Shastry
Epidermolysis bullosa (EB) pruriginosa is a very rare pattern of dystrophic EB caused by type VII collagen gene mutation, with distinctive clinico-pathological features. It is characterized by nodular prurigo-like lichenified lesions, nail dystrophy, and variable presence of albopapuloid lesions. We report two such cases.
January 2014: Indian Dermatology Online Journal
C Albarrán-Planelles, D Jiménez-Gallo, M Linares-Barrios, A Martínez-Rodríguez
A wide range of treatments are currently available for severe atopic dermatitis, including systemic therapies such as ciclosporin, corticosteroids, azathioprine, methotrexate, mofetil mycophenolate, and omalizumab. In patients who can no longer take systemic drugs or who need a dose reduction, wet-wrap treatment can be an excellent option. To date, wet wraps have mostly been used in severe cases of childhood atopic dermatitis. We report our experience with wet-wrap treatment in 5 adults with atopic dermatitis and 2 with nodular prurigo...
April 2014: Actas Dermo-sifiliográficas
Li-Ren Guan, Yuan-Qing Yang, Jing-Qi Qu, Hao-Yuan Ren, Jun-Jie Chai
Cutaneous leishmaniasis (CL) was discovered in the farms of the Karamay suburb, Xinjiang Uygur Autonomous Region in the 1990s. Between 1992 and 1994, a house-to-house survey revealed a prevalence of 1.0-1.6% in the residents. The clinical types of skin lesions included papule, plaque, ulcer and nodular prurigo. Observations verified that, in some cases, the skin lesions healed spontaneously in 10-14 months, whilst in other cases, they persisted for several years. Sporadic cases of CL have continued to appear at the dermatology clinic of the local hospital since 2000...
2013: Infectious Diseases of Poverty
Wayne Grayson
A large percentage of patients with HIV/AIDS will develop dermatological complications. Consequently, all practising clinicians and pathologists in regions with a high prevalence of HIV/AIDS must be familiar with the diverse cutaneous manifestations of the disease. This paper highlights the fact that biopsy material in this clinical context may occasionally reveal more than one pathological process. The potential spectrum includes two or more infections in a single skin biopsy (e.g., herpes simplex and cytomegalovirus infection), neoplastic lesions containing infective organisms (Kaposi sarcoma (KS) and cryptococcosis), dermatoses in association with neoplastic lesions (e...
2011: Pathology Research International
Xiao-jie Huang, Hai-ying Li, De-xi Chen, Xi-cheng Wang, Zai-chun Li, Ya-song Wu, Tong Zhang, Yan-qing Gao, Hao Wu
Skin lesions are often associated with human immunodeficiency virus (HIV) infection, reflecting the immunocompromised status of the individual. We investigated the relationship between skin lesions and immune function in a retrospective study of 796 Chinese HIV patients with and without highly active antiretroviral therapy (HAART). Of the 651 patients who had not received HAART, we found that 531 (81.6%) had apparent skin lesions. The incidence of infectious skin diseases (fungi, viruses, bacteria, spirochetes and parasites) and non-infectious skin diseases (excluding skin cancer) was 68...
September 2011: Acta Dermato-venereologica
C Covaciu, F Grosso, E Pisaneschi, G Zambruno, P A Gregersen, M Sommerlund, J M Hertz, D Castiglia
Dystrophic epidermolysis bullosa pruriginosa (DEB-Pr) (OMIM 604129) represents a distinct variant within the DEB clinical spectrum. It is characterized by intense pruritus and distinctive nodular prurigo-like and/or hypertrophic lichenoid lesions mainly localized on the arms, legs and upper shoulders. DEB-Pr is caused by either dominant (DDEB-Pr) or recessive mutations in the COL7A1 gene encoding type VII collagen (COLVII). The full spectrum of COL7A1 mutations in DEB-Pr remains elusive and the genotype-phenotype correlation is largely incomplete...
September 2011: British Journal of Dermatology
Eugene Tan, David Lim, Marius Rademaker
BACKGROUND: Phototherapy is effective for many dermatoses in adults, but there is a paucity of data for its use in children. OBJECTIVES: To review the efficacy and tolerability of narrowband UVB phototherapy in children at a tertiary centre in New Zealand, and determine if there were any factors that differentiated responders from non-responders. METHODS: A prospective analysis of children (<16 years old) who had undergone phototherapy over a 15-year period...
November 2010: Australasian Journal of Dermatology
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