{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:54:00Z","timestamp":1780707240603,"version":"3.54.1"},"reference-count":59,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,11,30]],"date-time":"2009-11-30T00:00:00Z","timestamp":1259539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:p> <jats:bold>Background:<\/jats:bold> To date, there has been no systematic investigation of the detailed histological features of prurigo nodularis (PN) in a large cohort of patients.<\/jats:p><jats:p> <jats:bold>Methods:<\/jats:bold> This retrospective study includes skin biopsies of 136 patients (63 males, 73 females; mean age: 58.38 years) with PN.<\/jats:p><jats:p> <jats:bold>Results:<\/jats:bold> Highly characteristic for PN is the presence of thick compact orthohyperkeratosis; the hairy palm sign (folliculosebaceous units in nonvolar skin in conjunction with a thick and compact cornified layer, like that of volar skin); irregular epidermal hyperplasia or pseudoepitheliomatous hyperplasia; focal parakeratosis; hypergranulosis; fibrosis of the papillary dermis with vertically arranged collagen fibers; increased number of fibroblasts and capillaries; a superficial, perivascular and\/or interstitial inflammatory infiltrate of lymphocytes, macrophages and, to a lesser extent, eosinophils and neutrophils. For comparison, histological findings in 45 patients (18 males, 27 females; mean, 55.64 years) with lichen simplex (LS) were studied. PN and LS, both of them scratch\u2010induced, had 50 of 58 (86.2%) histological features in common.<\/jats:p><jats:p> <jats:bold>Conclusions:<\/jats:bold> PN revealed a characteristic histological pattern. Absence of pseudoepitheliomatous hyperplasia or nerve fiber thickening, however, does not rule out the histological diagnosis of PN. A correlation of clinical and histological findings is necessary to reliably distinguish between PN and LS.<\/jats:p><jats:p>Weigelt N, Metze D, St\u00e4nder S. 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