Clinical characteristics and disease burden in prurigo nodularis

Abstract

Background Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by intense pruritus, but information on patient experience and impact on quality of life (QoL) remains understudied. Objective To characterize disease characteristics and QoL in a global sample of PN patients. Methods An anonymous survey distributed via PN patient support groups. Results A total of 231 members responded to the survey. The majority of respondents reported itch localized to both nodules and intervening skin (67.0%). Associated symptoms included prickling, pain, stinging, and burning. The extensor lower legs (69% right, 67.3% left) and flexor forearms (66.1% right, 62% left) were the most common sites of itch. Participants reported frequent healthcare utilization with 36.3% visiting a doctor ≥10 times in the past year. Physician‐diagnosed anxiety (45.4%), depression (16.4%), and the atopic triad (18.7%) were commonly reported. PN patients had a mean Dermatology Quality Life Index score of 16.4, 5D Itch score of 16.8 and Pittsburgh Sleep Quality Index score of 11.6. Conclusions Severe pruritus with accompanying pain, stinging, and burning is characteristic of PN, with the majority experiencing itch in both nodular and interlesional skin. Patients further report decreased QoL scores and impaired sleep. Patient experiences should guide future management of PN.