Prurigo Nodularis: Causes, Symptoms, and Treatments
 

Do you ever experience intense bouts of itchiness? Has your itch skin ever formed hard, crusty bumps that seem to make your itching worse? Have you looked for relief on your own, only to come up short?

If you have, you possibly have a case of prurigo nodularis.

This article will explain what prurigo nodularis is, as well as its causes, symptoms, and treatments.

What is Prurigo Nodularis?

Prurigo nodularis is a fairly rare skin condition. According to the US National Library of Medicine’s National Institutes of Health, prurigo nodularis is most commonly known for chronic, intensely itchy nodules. The NIH also says that prurigo nodularis is usually considered an idiopathic disease, meaning that it develops spontaneously with seemingly no rhyme or reason.

 
Prurigo nodularis is a fairly rare skin condition. It is most commonly known for chronic, intensely itchy nodules.
 

Although medical experts, researchers, doctors, and dermatologists don’t know exactly what causes prurigo nodularis, there are several competing theories.

Causes of Prurigo Nodularis

Experts aren’t exactly sure what causes prurigo nodularis. According to the National Center for Advancing Translational Sciences’ Genetic and Rare Diseases Information Center, there are two, main theories of what causes prurigo nodularis.

Theory 1 - Infection

The first theory is that prurigo nodularis is mostly caused by a simple skin infection. The idea is that, at some point, the skin became scratched or irritated, and that’s why the patient starts scratching in the first place. This theory makes sense when you consider that many patients with prurigo nodularis have medical histories that include skin conditions like eczema or other skin-related allergies. Eczema makes someone more susceptible to skin infections and allergies can further irritate the skin.

The main problem with this theory is that it’s hard to pin down what the exact catalyst is to that first infection. It’s really hard to recommend prevention measures when something as simple as “itchy skin” is responsible for further infections. This first theory might be a little too broad to be particularly useful.

Theory 2 - Thick Nerves

The second theory has to do with thickened nerves. Often, when a doctor performs a biopsy on a patient with prurigo nodularis, they’ll see that the nerves located in that skin tissue have thickened. This theory states that these thick nerves send stronger signals to the brain than their thinner, healthier counterparts. The patient's brain interprets these strong signals as the body experiencing extreme sensations.

So, when a patient is experiencing normal itching, their brain thinks it’s experiencing something more intense than it really is. This causes them to continually scratch at severe itches that don’t really exist. The skin, now irritated by the excessive scratching, begins to form bumps, These bumps worsen the sensation felt by the thickened nerves, which in turn, causes the brain to think that the itching is getting even worse. This causes more scratching, which leads to more bumps, which causes even more scratching.

The problem with this theory is that not only are medical experts and researchers unsure how or why these nerves are starting to thicken, but they also don’t have an explanation for what causes the itch in the first place. Everyone feels itchy sometimes, but that’s not the same as a patient feeling itchy long enough where the scratching starts to irritate the skin in earnest.

Symptoms of Prurigo Nodularis

The symptoms of prurigo nodularis are pretty straightforward according to the National Center for Advancing Translational Sciences’ Genetic and Rare Diseases Information Center.

Prurigo nodularis’ most recognizable symptom is the formation of hard, itchy lumps or nodules on the skin. These lumps can be very small or they can be very large. They can grow up to half an inch in diameter.

These nodules have dry tops that feel rough to the touch. A patient with prurigo nodularis will have anywhere from a couple of nodules on their body to a few hundred. These nodules usually appear on the outer arms, shoulders, and legs, but they can also appear on the neck or the torso. These bumps rarely appear, however, on the palms or face. It really depends on the individual.

 
These nodules usually appear on the outer arms, shoulders, and legs, but they can also appear on the neck or the torso.
 

Prurigo nodularis bumps can look lighter or darker than the surrounding skin color.

The only thing that they all hold in common is that, at some point, the bumps or nodules begin to itch severely. The itching is so severe that it may prevent you from getting a full night’s rest or prevent you from enjoying other daily activities.

Patients with prurigo nodularis can develop depression or stress because of the intensity of the itching.

Prurigo Nodularis Treatment Options

Prurigo nodularis is a difficult condition to treat. There is no, one treatment that works for everyone. Some people find that none of the treatments work very well. The American Osteopathic College of Dermatology (AOCD) outlined a couple of different treatment options patients with prurigo nodularis may want to talk about with their doctor or dermatologist.

Possible prurigo nodularis treatment options include:

  • Steroid Creams
  • Antihistamine creams
  • Intralesional steroid injections
  • Cryotherapy
  • Oral steroids

Others also recommend trying capsaicin cream or an ointment that contains menthol.

Ask your doctor which treatment he or she thinks would work best for you and your specific case. Also, be sure to ask them why, so you can understand the reasoning behind your treatment.

No matter what your doctor recommends, all prurigo nodularis treatments are paired with therapy. Since prurigo nodularis is considered in part to be a self-causing skin-disease, it’s important that you receive the help and training you need so you can avoid scratching your own skin. No amount of cream can counteract over enthusiastic scratching.

 
It’s important that you receive the help and training you need so you can avoid scratching your own skin.
 

Be Prepared to Recognize Prurigo Nodularis

Most people never develop prurigo nodularis. It’s quite possible that if you’re experiencing an itchy sensation, that you’re dealing with a different problem altogether.

This is why it’s so important to schedule an appointment with your doctor or dermatologist so he or she can officially diagnose you. If you have prurigo nodularis, then you need treatment and therapy immediately before you make your own condition worse.

If you don’t have prurigo nodularis, those treatments probably won’t help you anyway.

No matter what condition you have, hopefully, you now feel more prepared to recognize the symptoms of prurigo nodularis before they get any worse.