Resolution of Treatment-Refractory Prurigo Nodularis With Dupilumab: A Case Series.

Jill K Wieser,Kathryn Somers,Mary Gail Mercurio

doi:10.7759/cureus.8737

Abstract

Prurigo nodularis is a pruritic skin condition that can present therapeutic challenges. We present a series of three patients diagnosed with prurigo nodularis who had failed several commonly trialed therapies, but experienced relief from symptoms and improvement in skin lesions following initiation of dupilumab therapy. All patients in this series lacked a diagnosis of atopic dermatitis and had lesions on the lower extremities, although other locations such as the trunk were also involved. Continued study of dupilumab in patients with prurigo nodularis is advocated.

Highlights

Prurigo nodularis (PN) is a chronic cutaneous condition associated with intense pruritus
We present a case series of three patients without atopic dermatitis (AD) who experienced dramatic improvement in both itch and clinical appearance of lesions following treatment with dupilumab
Dupilumab, which inhibits signaling of IL-4 and IL-13, has demonstrated efficacy and safety in a retrospective review of 90 AD patients with the generalized PN phenotype [4]

Summary

Introduction

Prurigo nodularis (PN) is a chronic cutaneous condition associated with intense pruritus. He did not experience significant relief with this regimen; dupilumab was initiated He experienced a significant improvement in both pruritus and cutaneous lesions by his follow-up appointment one month later (Figure 2B). He noted a reduction in itch and denied adverse events from dupilumab. A 65-year-old woman presented with a three-year history of PN on the trunk and extremities (Figure 3A) She had a remote history of asthma and allergic rhinitis and no longer received treatment for these conditions, but no history of AD. Her symptoms and cutaneous nodules had significantly improved by her subsequent visit seven months later (Figure 3B) She endorsed a reduction in pruritus and denied side effects from dupilumab.

Discussion

Conclusions

Findings

Disclosures