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Prurigo Nodularis (PN)


 

Prurigo Nodularis (PN)

This is a skin disease that causes hard, itchy lumps (nodules) to form on the skin. Recently, its incidence is increasing very much. Some of the nodules start with insect bites in limbs, which gradually spread to the trunk, and in the worst case they can reach the whole body. Probably some viruses are involved in it. Prurigo Nodularis (PN) is a completely different skin disease from psoriasis, palmoplantar pustulosis, atopic dermatitis, and scabies. Everyone can get PN, regardless of age, gender, or race.
PN does not develop immediately after being bitten by an insect. In many cases, after three months to a half year later, very itchy lumps are gradually start forming from the limbs.
The patient may not know the reason and remain very confused. However, when asked in detail, they can explain of their trip to a mountain half a year ago, and there are reasons such as having been bitten by a black fly. If you suffer from PN, try to remember camping trip in mountains. Or bitten by mosquitoes in your back yard. Or even by a cat at home. There are, of course, cases where the cause is unknown at all. Some patients with serious atopic dermatitis can suffer from PN concomitantly without any bites. And PN patients sometimes have a history of other diseases such as lymphoma, HIV infection, and so on.

Usually the treatment is done with ultraviolet radiation therapy with narrow band UVB, or cryotherapy with liquid nitrogen, or local injection of steroids. However, the condition is troublesome when the symptoms do not go away with those applications. Among skin diseases, following mycosis fungoides and scabies, PN causes most serious itch. More itchy than atopic dermatitis. Therefore, patients often cannot do without even oral administration of steroid pills such as prednisolone. Just recently, I examined a patient with PN who well understood the side effects of steroid pill but couldn't help taking the pill continuously. She had a moon face due to the side effect of the pill. She knew well it. But she cannot stop the pill.

But you should not give up the improvement. 80 - 90 % of itchy lumps will be eradicated in 3 to 4 months by our unique treatment. Without steroid pills or immunesuppressants or very expensive Dupilumab (Dupixent), you can be free from the serious itching, and can sleep well. You will not worry about the appearance of the nodules. Sure!!

 


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