{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:55:41Z","timestamp":1787320541668,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The pathogenesis of prurigo nodularis (PN) is considered to be multifactorial, with numerous cells and cytokines confabulating to produce an aberrant immune response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional observational study was done in cases of untreated primary prurigo nodularis cases with histopathological assessment in 49 cases from lesional and nonlesional skin with assessment of epidermal and dermal changes, dermal infiltrate, S\u2010100 and\u00a0toluidine blue staining to assess the expression of nerve and mast cells.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The most common histological changes seen in lesional skin were hyperkeratosis (98%), irregular hyperplasia (69.4%), hypergranulosis (69.4%), subepidermal clefting (6%), vertical collagen bundles (51.0%), and dermal fibrosis (48.9%). Chronic inflammatory infiltrate was seen in all cases (100%) predominantly of lymphocytes (100%) followed by eosinophils (18.4%), plasma cells (8.2%), and neutrophils (2.0%). There was a marked increase in the expression of S\u2010100 (6.92\u2009\u00b1\u20093.40 vs. 3.94\u2009\u00b1\u20092.15,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and toluidine blue (4.99\u2009\u00b1\u20094.47 vs. 1.22\u2009\u00b1\u20091.28,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) in the lesional skin as compared to the nonlesional skin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We can infer that the epidermal and dermal pathology in PN is related to the infiltrate of lymphocytes, mast cells, and neural hyperplasia which perpetuate the pathogenesis by triggering the itch\u2010inflammation cycle. Thus, apart from immunosuppressive agents that target lymphocytes and their cytokines, therapy targeted at mast cells and neural proliferation may be needed to treat prurigo nodularis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.16834","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T05:16:55Z","timestamp":1695791815000},"page":"1352-1358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A case\u2013control study addressing the population of epidermal and dermal inflammatory infiltrate including neural milieu in primary prurigo nodularis using S\u2010100 and toluidine blue stain and its therapeutic implications"],"prefix":"10.1111","volume":"62","author":[{"given":"Diksha","family":"Agrawal","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy Venkateshwara Institute of Medical Sciences  Amroha Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-3406","authenticated-orcid":false,"given":"Kabir","family":"Sardana","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STDs Dr RML Hospital and ABVIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinu Rose","family":"Mathachan","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STDs Dr RML Hospital and ABVIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minakshi","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"Department of Pathology Dr. RML Hospital and ABVIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Department of Pathology Dr. RML Hospital and ABVIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swasti","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pathology Dr. RML Hospital and ABVIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeet","family":"Panesar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Dr. RML Hospital and ABVIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"Practical treatise on diseases of the skin for the use of students and practitioners","author":"Hyde JN","year":"1909"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14570"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2774"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2012.04481.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10498.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.14709"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.767"},{"key":"e_1_2_5_9_1","first-page":"897","article-title":"Le neurome de la lichenification circonscrite nodulaire chronique (lichen rubber obtusus corne prurigo nodularis)","volume":"7","author":"Pautrier LM","year":"1934","journal-title":"Ann Dermatol Syph"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2232"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2009.01484.x"},{"key":"e_1_2_5_12_1","volume-title":"Weedon \u2018s skin pathology","author":"Johnston RB","year":"2016"},{"issue":"3","key":"e_1_2_5_13_1","first-page":"477","article-title":"A case for diagnosis; lichen obtusus? 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