L28.1

Clinical Causes: Chronic itching or skin inflammation Underlying skin conditions such as eczema or psoriasis Nerve damage or neurological disorders Immunological factors causing abnormal skin responses Psychological factors like stress or obsessive scratching Other systemic diseases such as liver or kidney disease

Key Symptoms: Multiple, firm, raised nodules that are often skin-colored, red, or hyperpigmented Intense itching that can worsen at night or during stress Nodules may become thickened or crusted from repeated scratching Possible appearance of excoriations or ulcerations due to scratching Skin changes such as thickening, hyperpigmentation, or hypopigmentation around nodules Distribution of lesions commonly occurs on the arms, legs, back, or shoulders

Diagnosis Path: Diagnosis of prurigo nodularis generally involves a detailed medical history and physical examination. Doctors look for characteristic nodules and assess the pattern of skin involvement. A skin biopsy may be performed to exclude other skin diseases and confirm the diagnosis, revealing features such as hyperkeratosis, acanthosis, and infiltration of inflammatory cells. Blood tests might also be recommended to identify underlying conditions contributing to the disease.

Treatment Protocols: Managing prurigo nodularis involves a combination of therapies aimed at reducing itchiness, controlling inflammation, and preventing the formation of new nodules. Common approaches include: - Topical corticosteroids to decrease inflammation - Antihistamines to control itching - Moisturizers and emollients to keep the skin hydrated - Intralesional corticosteroid injections for stubborn nodules - Phototherapy, such as ultraviolet B (UVB) therapy - Systemic treatments like immunosuppressants or antidepressants in severe cases - Addressing underlying causes or comorbidities that may contribute to the condition Importantly, preventing scratching and avoiding skin trauma are crucial components of disease management.