[Translated article] Chronic Nodular Prurigo: A Retrospective Study of 74 Cases

• Published in: Actas dermo-sifiliográficas 2022-10, Vol.113 (9), p.T866-T873
• Main Authors: Espiñeira Sicre, J., Docampo Simón, A., Silvestre Salvador, J.F.
• Format: Article
• Language: English
• Subjects: Biopsia cutánea; Case series; Chronic nodular prurigo; Comorbidities; Comorbilidades; Immunoglobulin E; Inmunoglobulina E; Multidisciplinar; Multidisciplinary; Prurigo crónico nodular; Prurito; Pruritus; Serie de casos; Skin biopsy
• ISSN: 0001-7310
• DOI: 10.1016/j.ad.2022.08.012

Chronic nodular prurigo (CNPG) is a recently defined and currently underdiagnosed disease with a variety of causes. It is associated with multiple comorbidities, and its management and treatment have improved with a better understanding of its pathogenesis. The aim of this study was to describe our experience with a series of patients with CNPG. Single-center, observational, retrospective study of the sociodemographic and clinical characteristics of patients with CNPG seen at the dermatology department of a tertiary care hospital between 2009 and 2021. We included 74 patients, mostly women (63.5%), with a mean age of 57 years. Overall, 39.2% of patients had a concomitant skin condition, mainly atopic dermatitis (62%). Other comorbidities included endocrine disorders (54.1%), cardiovascular disease (44.4%), and psychiatric disorders (36.5%). Skin biopsy helped confirm the clinical diagnosis in 70% of cases. The mean immunoglobulin E level was higher than normal (516IU/mL), regardless of atopic predisposition. On average, patients received three treatments, the most common choices being methotrexate, antihistamines, and topical and oral corticosteroids. Methotrexate was among the most effective options. CNPG is a complex disease associated with multiple comorbidities. It requires a multidisciplinary approach, with the dermatologist at the center. Classical treatment approaches are probably insufficient. El prurigo crónico nodular (PCN) es una enfermedad recientemente definida, de etiología heterogénea e infradiagnosticado en la actualidad. Está asociado a múltiples comorbilidades y los avances en su patogenia han abierto puertas a un mejor manejo y tratamiento. Presentamos una serie de pacientes con PCN con el objetivo de aportar nuestra experiencia en el manejo de esta entidad. Se realizó un estudio observacional, retrospectivo y unicéntrico que incluye pacientes con PCN atendidos en el Servicio de Dermatología de un hospital terciario entre 2009 y 2021. Se recogieron variables sociodemográficas y clínicas. Se incluyeron 74 pacientes, mayoritariamente mujeres (63,5%), con una media de 57años. La asociación del PCN con otras enfermedades cutáneas fue del 39,2%, sobre todo dermatitis atópica (62%). El 54,1% de los pacientes presentaron comorbilidad endocrina y el 44,4%, comorbilidad cardiovascular. La asociación con enfermedad psiquiátrica fue del 36,5%. La biopsia cutánea fue útil para confirmar la sospecha clínica en el 70% de los casos. El valor medio de l