{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:58:58Z","timestamp":1772006338904,"version":"3.50.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Allergy"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prurigo nodularis (PN) is a chronic inflammatory dermatosis that often coexists with atopic dermatitis (AD) but represents a distinct entity. Evidence directly comparing PN and AD in Chinese populations remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize clinical distinctions between PN and AD in Chinese adults and to explore whether total serum immunoglobulin E (IgE) status delineates distinct clinical profiles within PN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter case\u2013control study enrolled 2,621 adult patients (\u226518 years) including 1,462 with PN and 1,159 with AD. Multivariable logistic regressions were used to evaluate independent associations differentiating PN from AD and to examine IgE-defined clinical heterogeneity within PN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with AD, PN was independently associated with middle age, rural residence, lower education, smoking, and an overall reduced atopic profile, and was more frequently accompanied by type 2 diabetes mellitus and psychiatric disorders. Within PN, the IgE-high subgroup displayed a pronounced type 2 immune response-associated inflammatory profile, including peripheral eosinophilia and allergen sensitization, whereas IgE-normal patients showed comparatively attenuated atopic markers. In contrast, sociodemographic correlates that distinguished PN from AD were not consistently different between IgE-defined PN subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Chinese adults, PN exhibits clinical heterogeneity with two distinct patterns: one characterized by variability in type 2 immunity-associated and atopic features, and the other by a substantial burden of specific sociodemographic and metabolic comorbidities. Serum IgE may serve as a practical marker for stratifying type 2 immunity and atopic variability in PN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/falgy.2026.1769768","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:02:40Z","timestamp":1772002960000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["IgE-defined endotypes reveal distinct clinical profiles of prurigo nodularis compared with atopic dermatitis: a multicenter study in China"],"prefix":"10.3389","volume":"7","author":[{"given":"Shihua","family":"Ling","sequence":"first","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]},{"name":"Shantou University Medical College","place":["Shantou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaofeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruimiao","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengting","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiyan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]},{"name":"Shenzhen Key Laboratory for Translational Medicine of Dermatology, Institute of Dermatology, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Dou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Shenzhen Hospital","place":["Shenzhen, China"]},{"name":"Shenzhen Key Laboratory for Translational Medicine of Dermatology, Institute of Dermatology, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s40257-023-00818-z","article-title":"Chronic prurigo including prurigo nodularis: new insights and treatments","volume":"25","author":"M\u00fcller","year":"2024","journal-title":"Am J Clin Dermatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1016\/j.jaad.2021.05.036","article-title":"Health-related quality of life and economic burden of prurigo nodularis","volume":"86","author":"Whang","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.jid.2019.07.697","article-title":"Real-World prevalence of prurigo nodularis and burden of associated diseases","volume":"140","author":"Huang","year":"2020","journal-title":"J Invest Dermatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1111\/bjd.21032","article-title":"Epidemiology of prurigo nodularis in England: a retrospective database analysis","volume":"187","author":"Morgan","year":"2022","journal-title":"Br J Dermatol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"adv00155","DOI":"10.2340\/00015555-3518","article-title":"Prevalence of prurigo nodularis in Poland","volume":"100","author":"Ryczek","year":"2020","journal-title":"Acta Derm Venereol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"95","DOI":"10.3390\/jcm11010095","article-title":"Epidemiology, comorbidities, and prescription patterns of Korean prurigo nodularis patients: a multi-institution study","volume":"11","author":"Woo","year":"2021","journal-title":"J Clin Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"100233","DOI":"10.1016\/j.xjidi.2023.100233","article-title":"Incident comorbidity, resource use, and all-cause mortality associated with prurigo nodularis: a United Kingdom retrospective database analysis","volume":"3","author":"Morgan","year":"2023","journal-title":"JID Innov"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e984","DOI":"10.1111\/jdv.20038","article-title":"Chronic nodular prurigo: association between comorbidities, itch and quality of life","volume":"38","author":"Pereira","year":"2024","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/j.jaad.2023.06.045","article-title":"Prevalence and comorbidity burden of prurigo nodularis in United States adults enrolled in the all of US research program","volume":"89","author":"Joel","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"20406223211002979","DOI":"10.1177\/20406223211002979","article-title":"Nomenclature and clinical phenotypes of atopic dermatitis","volume":"12","author":"Girolomoni","year":"2021","journal-title":"Ther Adv Chronic Dis"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e42","DOI":"10.1097\/itx.0000000000000042","article-title":"IFSI-guideline on chronic prurigo including prurigo nodularis","volume":"5","author":"St\u00e4nder","year":"2020","journal-title":"Itch (Phila)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1568","DOI":"10.1016\/j.jid.2023.12.021","article-title":"Single-cell RNA sequencing reveals dysregulated POSTN+WNT5A+ fibroblast subclusters in prurigo nodularis","volume":"144","author":"Patel","year":"2024","journal-title":"J Invest Dermatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.jaci.2023.07.005","article-title":"Single-cell profiling of prurigo nodularis demonstrates immune-stromal crosstalk driving profibrotic responses and reversal with nemolizumab","volume":"153","author":"Ma","year":"2024","journal-title":"J Allergy Clin Immunol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"adv44220","DOI":"10.2340\/actadv.v105.44220","article-title":"European S2k guideline on chronic pruritus","volume":"105","author":"Weisshaar","year":"2025","journal-title":"Acta Derm Venereol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1097\/CM9.0000000000003013","article-title":"Comorbidities of prurigo nodularis in Chinese patients: a multicenter retrospective study","volume":"137","author":"Yin","year":"2024","journal-title":"Chin Med J (Engl)"},{"key":"B16","doi-asserted-by":"publisher","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":"B17","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1111\/j.1365-2133.1994.tb08530.x","article-title":"The U.K. working party\u2019s diagnostic criteria for atopic dermatitis. I. derivation of a minimum set of discriminators for atopic dermatitis","volume":"131","author":"Williams","year":"1994","journal-title":"Br J Dermatol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2373","DOI":"10.1111\/jdv.16309","article-title":"Chronic nodular prurigo: clinical profile and burden. A European cross-sectional study","volume":"34","author":"Pereira","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1111\/1346-8138.17045","article-title":"Disease burden and treatment satisfaction in patients with prurigo nodularis in Japan","volume":"51","author":"Murota","year":"2024","journal-title":"J Dermatol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1016\/j.jid.2021.10.011","article-title":"Cluster analysis of circulating plasma biomarkers in prurigo nodularis reveals a distinct systemic inflammatory signature in African Americans","volume":"142","author":"Sutaria","year":"2022","journal-title":"J Invest Dermatol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1011142","DOI":"10.3389\/fmed.2022.1011142","article-title":"Circulating plasma IL-13 and periostin are dysregulated type 2 inflammatory biomarkers in prurigo nodularis: a cluster analysis","volume":"9","author":"Parthasarathy","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1016\/j.jaad.2023.01.042","article-title":"The blood proteomic signature of prurigo nodularis reveals distinct inflammatory and neuropathic endotypes: a cluster analysis","volume":"88","author":"Parthasarathy","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1159\/000246715","article-title":"Prurigo nodularis consists of two distinct forms: early-onset atopic and late-onset non-atopic","volume":"190","author":"Tanaka","year":"1995","journal-title":"Dermatology"},{"key":"B24","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1111\/j.1468-3083.2012.04481.x","article-title":"Prurigo as a symptom of atopic and non-atopic diseases: aetiological survey in a consecutive cohort of 108 patients","volume":"27","author":"Iking","year":"2013","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.jaci.2005.05.009","article-title":"Change in prevalence of IgE sensitization and mean total IgE with age and cohort","volume":"116","author":"Jarvis","year":"2005","journal-title":"J Allergy Clin Immunol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/s11882-011-0204-9","article-title":"Role of allergen sensitization in older adults","volume":"11","author":"Viswanathan","year":"2011","journal-title":"Curr Allergy Asthma Rep"},{"key":"B27","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1038\/nm.2678","article-title":"Asthma phenotypes: the evolution from clinical to molecular approaches","volume":"18","author":"Wenzel","year":"2012","journal-title":"Nat Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jaci.2019.05.031","article-title":"Phenotypes and endotypes of adult asthma: moving toward precision medicine","volume":"144","author":"Kaur","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1038\/s41591-023-02320-9","article-title":"Dupilumab in patients with prurigo nodularis: two randomized, double-blind, placebo-controlled phase 3 trials","volume":"29","author":"Yosipovitch","year":"2023","journal-title":"Nat Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.jdin.2024.03.025","article-title":"Dupilumab improves pruritus and skin lesions in patients with prurigo nodularis: pooled results from 2 phase 3 trials (LIBERTY-PN PRIME and PRIME2)","volume":"16","author":"Yosipovitch","year":"2024","journal-title":"JAAD Int"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1056\/NEJMoa2301333","article-title":"Phase 3 trial of nemolizumab in patients with prurigo nodularis","volume":"389","author":"Kwatra","year":"2023","journal-title":"N Engl J Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1056\/NEJMoa1908316","article-title":"Trial of nemolizumab in moderate-to-severe prurigo nodularis","volume":"382","author":"St\u00e4nder","year":"2020","journal-title":"N Engl J Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1093\/ced\/llaf105","article-title":"Circulating IgE levels as a biomarker for treatment response to dupilumab among patients with prurigo nodularis","volume":"50","author":"D'Amiano","year":"2025","journal-title":"Clin Exp Dermatol"}],"container-title":["Frontiers in Allergy"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/falgy.2026.1769768\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:02:41Z","timestamp":1772002961000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/falgy.2026.1769768\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":33,"alternative-id":["10.3389\/falgy.2026.1769768"],"URL":"https:\/\/doi.org\/10.3389\/falgy.2026.1769768","relation":{},"ISSN":["2673-6101"],"issn-type":[{"value":"2673-6101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"article-number":"1769768"}}