{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:43:41Z","timestamp":1791413021514,"version":"4.3.3"},"reference-count":88,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019944","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019944","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009857","name":"Regeneron Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017217","name":"Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017217","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Corinne S"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Prurigo nodularis (PN) is a distinct, chronic inflammatory skin disease characterized by intensely pruritic, fibrotic nodular lesions. Despite continued progress in the field, the lack of clarity regarding the definition of PN as a disease, its clinical presentation, and therapeutic options results in delayed diagnosis and management. PN can arise following other diseases, but once established, it is considered an independent disease. Here, we summarize current knowledge of the epidemiology, clinical characteristics, disease burden and management approaches that may help healthcare providers recognize PN as a primary diagnosis, independent of triggers or associated comorbidities. PN is more common among patients aged 50\u201360\u2005years, and some evidence suggests it is more frequent among Black populations than White and Asian populations. A subset of patients with PN have an atopic background and can present with comorbid atopic dermatitis; however, PN can also exist without atopic comorbidities. Other comorbidities typically include diabetes, obesity, thyroid disease, kidney disease, chronic liver disease, hypertension, HIV infection, skin infections, malignancies and mental health disorders. Multiple intensely pruritic lesions induce chronic scratching, which leads to inflammation, hyperkeratotic nodules and perpetuation of a vicious itch\u2013scratch cycle. PN is associated with a high disease burden and negative effect on quality of life; patients often report intense and relentless itching, poor sleep, absence from work, anxiety and depression. Early diagnosis of PN and identification of comorbidities are important to facilitate better disease management. By increasing their awareness of PN epidemiology, disease burden, clinical presentation and management, physicians may begin to identify the disease as a distinct condition, independent of its triggers or associated comorbidities and provide patients with appropriate care earlier in their treatment journeys.<\/jats:p>","DOI":"10.1093\/bjd\/ljaf213","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T03:26:25Z","timestamp":1752636385000},"page":"642-652","source":"Crossref","is-referenced-by-count":23,"title":["Prurigo nodularis: disease burden, clinical features and approach to management"],"prefix":"10.1093","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3736-1515","authenticated-orcid":false,"given":"Shawn G","family":"Kwatra","sequence":"first","affiliation":[{"name":"Department of Dermatology, University of Maryland School of Medicine , Baltimore, MD ,","place":["USA"]},{"name":"Maryland Itch Center, University of Maryland School of Medicine , Baltimore, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel P","family":"Pereira","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t Zu Berlin , Berlin ,","place":["Germany"]},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8088-7059","authenticated-orcid":false,"given":"Laurent","family":"Misery","sequence":"additional","affiliation":[{"name":"Department of Dermatology, French Expert Itch Center, University Hospital , Brest ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas K","family":"Mollanazar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Pennsylvania Perelman School of Medicine , Philadelphia, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parul","family":"Shah","sequence":"additional","affiliation":[{"name":"Regeneron Pharmaceuticals Inc. , Tarrytown, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simmi","family":"Wiggins","sequence":"additional","affiliation":[{"name":"Sanofi , Reading ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"2025091919454674200_ljaf213-B1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.2340\/00015555-2774","article-title":"Chronic prurigo of nodular type: a review","volume":"98","author":"Zeidler","year":"2018","journal-title":"Acta Derm Venereol"},{"key":"2025091919454674200_ljaf213-B2","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1056\/NEJMe1916733","article-title":"Breaking the itch-scratch cycle in prurigo nodularis","volume":"382","author":"Kwatra","year":"2020","journal-title":"N Engl J Med"},{"key":"2025091919454674200_ljaf213-B3","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1080\/17512433.2021.1852080","article-title":"Pathophysiology, diagnosis, and pharmacological treatment of prurigo nodularis","volume":"14","author":"Williams","year":"2021","journal-title":"Expert Rev Clin Pharmacol"},{"key":"2025091919454674200_ljaf213-B4","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.jaad.2020.07.025","article-title":"Practical approaches for diagnosis and management of prurigo nodularis: United States expert panel consensus","volume":"84","author":"Elmariah","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"2025091919454674200_ljaf213-B5","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1111\/jdv.14570","article-title":"European Academy of Dermatology and Venereology European Prurigo Project: expert consensus on the definition, classification and terminology of chronic prurigo","volume":"32","author":"Pereira","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025091919454674200_ljaf213-B6","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1111\/exd.13972","article-title":"St\u00e4nder S. 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