Chronic itching and scratching
Lichenified lesions with exaggerated skin lines overlying a thickened, well-circumscribed scaly plaque
Predilection for nape of neck, wrists, external surfaces of forearms, lower legs, scrotum, and vulva
Dry, leathery, hypertrophic, lichenified plaques appear on the neck, ankles, or perineum
Patches are rectangular, thickened, and hyperpigmented
Skin lines are exaggerated
Psoriasis (redder lesions having whiter scales on the elbows, knees, and scalp and nail findings)
Lichen planus (violaceous, usually smaller polygonal papules)
Atopic dermatitis (eczema)
Nummular eczema or dermatitis (coin-shaped)
Chronic atopic dermatitis
See Table 6–2
Ultra-high potency topical corticosteroids are effective with or without occlusion and when used twice daily for several weeks
In some patients, flurandrenolide (Cordran) tape may be effective, since it prevents scratching and rubbing of the lesion
The injection of triamcinolone acetonide suspension (5–10 mg/mL) into the lesions may occasionally be curative
et al; French Group of Research and Study in Atopic Dermatitis (Groupe de Recherche sur l'Eczéma Atopique, GREAT) from the French Society of Dermatology (SFD). Effectiveness and safety of dupilumab for the treatment of prurigo nodularis in a French multicenter adult cohort of 16 patients. J Eur Acad Dermatol Venereol. 2020;34:e74.
et al. Less painful and effective intralesional injection method for lichen simplex chronicus. J Am Acad Dermatol. 2018;79:e105.
et al. A systematic review of evidence-based treatments for prurigo nodularis. J Am Acad Dermatol. 2019;80:756.