BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administ...BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administration has approved,which leads to very variable practices in the prescription of off-label treatments.Treatment of PN is based on clinical experience rather than controlled trials.We present our case of generalized PN,in which we had a dramatic response with dupilumab.CASE SUMMARY A 58-year-old female patient was admitted to our clinic with severe itchy,erythematous nodular lesions that were widespread all over her body,especially on the legs and back.It was learned that the patient's complaints started 4 years ago,and there was a significant increase in the lesions in the last period.Dermatological examination revealed diffuse firm erythematous excoriated nodular lesions all over the body.In the blood tests of the patient,serum Immunoglobulin E(IgE)was measured at 9330 IU/mL.The patient was diagnosed with generalized prurigo nodularis together with clinical and histopathological findings.Due to severe clinical findings and the presence of comorbidities,dupilumab treatment was planned for the patient.In the follow-up 4 mo later,it was observed that all nodular lesions healed with postinflammatory hypopigmentation.The IgE value decreased to 1500 IU/mL after 4 mo of dupilumab treatment.CONCLUSION Dupilumab treatment stands out as an effective and safe systemic treatment agent among existing systemic treatments.展开更多
The patient with prurigo nodularis were treated by needling at Bǎihuì（百会 GV 20）, Fēngchi（风池 GB 20）,Fēngfǔ（风府 GV 16）, Dàzhuī（大椎 GV 14）,Fēngmén（风门 BL 12）, Xīnshù（心俞 BL 1...The patient with prurigo nodularis were treated by needling at Bǎihuì（百会 GV 20）, Fēngchi（风池 GB 20）,Fēngfǔ（风府 GV 16）, Dàzhuī（大椎 GV 14）,Fēngmén（风门 BL 12）, Xīnshù（心俞 BL 15）, Gānshù（肝俞 BL18）, Qìhǎi（气海 CV 6）,Guānyuán（关元 CV 4）, Zhōngwǎn（中脘 CV12）, Xuèhǎi（血海 SP 10）, Zúsānlǐ（足三里ST 36）, Sānyīnjiāo（三阴交 SP 6）, Nèiting（内庭 ST 44）,Qūchí（曲池 LI 11）, Wàiguān（外关 TE 5） and Hégǔ（合谷 LI 4）. The treatment was given 4 times a week. After 2 weeks of treatment, the subjective pruritus was alleviated and tolerable. The patients could fall into sleep. After 2 months of treatment, no new skin rashes appear and pruritus disappeared basically, the old rashes started fading. The red color was getting pale and the bumpy rashes were absorbed. After 5 months of treatment, the itching symptoms were gone and skin rashes disappeared basically. The lesion skin was pigmented in dark grey. After 6 months of treatment, the dark grey pigmentation disappeared and skin was normal in color. The disease was not recurred in 1 year of follow-up.展开更多
文摘BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administration has approved,which leads to very variable practices in the prescription of off-label treatments.Treatment of PN is based on clinical experience rather than controlled trials.We present our case of generalized PN,in which we had a dramatic response with dupilumab.CASE SUMMARY A 58-year-old female patient was admitted to our clinic with severe itchy,erythematous nodular lesions that were widespread all over her body,especially on the legs and back.It was learned that the patient's complaints started 4 years ago,and there was a significant increase in the lesions in the last period.Dermatological examination revealed diffuse firm erythematous excoriated nodular lesions all over the body.In the blood tests of the patient,serum Immunoglobulin E(IgE)was measured at 9330 IU/mL.The patient was diagnosed with generalized prurigo nodularis together with clinical and histopathological findings.Due to severe clinical findings and the presence of comorbidities,dupilumab treatment was planned for the patient.In the follow-up 4 mo later,it was observed that all nodular lesions healed with postinflammatory hypopigmentation.The IgE value decreased to 1500 IU/mL after 4 mo of dupilumab treatment.CONCLUSION Dupilumab treatment stands out as an effective and safe systemic treatment agent among existing systemic treatments.
文摘The patient with prurigo nodularis were treated by needling at Bǎihuì（百会 GV 20）, Fēngchi（风池 GB 20）,Fēngfǔ（风府 GV 16）, Dàzhuī（大椎 GV 14）,Fēngmén（风门 BL 12）, Xīnshù（心俞 BL 15）, Gānshù（肝俞 BL18）, Qìhǎi（气海 CV 6）,Guānyuán（关元 CV 4）, Zhōngwǎn（中脘 CV12）, Xuèhǎi（血海 SP 10）, Zúsānlǐ（足三里ST 36）, Sānyīnjiāo（三阴交 SP 6）, Nèiting（内庭 ST 44）,Qūchí（曲池 LI 11）, Wàiguān（外关 TE 5） and Hégǔ（合谷 LI 4）. The treatment was given 4 times a week. After 2 weeks of treatment, the subjective pruritus was alleviated and tolerable. The patients could fall into sleep. After 2 months of treatment, no new skin rashes appear and pruritus disappeared basically, the old rashes started fading. The red color was getting pale and the bumpy rashes were absorbed. After 5 months of treatment, the itching symptoms were gone and skin rashes disappeared basically. The lesion skin was pigmented in dark grey. After 6 months of treatment, the dark grey pigmentation disappeared and skin was normal in color. The disease was not recurred in 1 year of follow-up.
