From the Research
Prurigo nodules should be treated with high-potency topical corticosteroids, such as clobetasol propionate 0.05%, applied twice daily for 2-4 weeks, followed by a maintenance regimen to prevent recurrence, as this approach has been shown to be effective in managing the condition and improving quality of life 1.
Treatment Approach
The treatment of prurigo nodules typically involves a combination of topical and systemic therapies.
- High-potency topical corticosteroids, such as clobetasol propionate 0.05%, are commonly used as first-line treatment, applied twice daily for 2-4 weeks, followed by a maintenance regimen of once daily or every other day application to prevent recurrence.
- Intralesional corticosteroid injections, such as triamcinolone acetonide 5-10 mg/ml, may be administered directly into the nodules every 3-4 weeks for severe cases.
- Oral antihistamines, such as hydroxyzine 25-50 mg at bedtime, can help control itching and improve sleep.
- Newer treatments, such as dupilumab (300 mg subcutaneously every two weeks), may be considered for refractory cases.
Underlying Causes
Identifying and treating underlying causes, such as atopic dermatitis, renal disease, or liver dysfunction, is essential for long-term management of prurigo nodules 2.
Quality of Life
Proper skin hydration with emollients and avoiding irritants can help prevent new lesions from forming and improve quality of life 3.
Diagnosis
The diagnostic workup involves a complete review of systems, considering potential systemic diseases, and assessment of disease severity, including disease burden and pruritus intensity 3.