Prurigo nodularis

Prurigo nodularis

Description, Causes and Risk Factors:

An eruption of hard, dome-shaped nodules in the skin caused by rubbing and accompanied by intense itching; occasionally due to mycobacterial infection, the cause is usually unknown.

Prurigo nodularis simply means "itchy bumps." It is an intense skin disease of itchy bumps, which usually appears on the arms or legs and later on tends to spread to other parts of the body.

The root cause of prurigo nodularis is difficult to define because it is caused by different things in different people. Many of the causes are yeast infections, toxins, fungal infections, poor diet, poor liver function, parasites and the list goes on.

It is important to understand the symptoms of yeast infections, fungal infections and parasites as they can mimic many diseases and create allergies. These infections are hard to diagnose and can lead to confusion as to what is really causing your case of itchy bumps. This is another reason why it is important to change your diet because a poor diet is what these infections thrive on.

Quite a few doctors/dermatologists will tell you that you did this to yourself because you scratched too much, the "itch-scratch cycle". That is absolute rubbish. Bumps can appear in areas that were never scratched before. Prurigo nodularis will not go away if you stop scratching though scratching will make it worse, eventually causing bleeding and scabs, which will then lead to scars.

The prognosis is unsatisfactory. If the underlying condition improves, improvement can be expected.


Once again the key feature is pruritus. The lesions are almost limited to the distal aspect of the extremities, in contrast to prurigo simplex subacuta. The face and trunk are spread. There is usually a modest number of symmetrically distributed, isolated firm nodules with a size ranging from 0.5 to 3.0 cm. The intervening skin is normal or occasionally hyperpigmented. Early lesions prurigo simplex acuta, hypopigmented often atrophic scars with a hyperpigmented periphery are common. Thus a dimorphous picture develops with crusted lesions and scars, but only rarely with primary lesions. Lichenified lesions seen so often in other itchy dermatoses do not develop. The palms, soles, and mucosa are spread.

The microscopic features reflect the clinical stages. The acute stage is identical to prurigo simplex acuta; in some reports, the early edema is within the follicular epithelium. Later the epidermis is acanthotic and may contain lymphocytes and eosinophils, often located within an intraepidermal or subcorneal blister. The excoriation comes to dominate the picture, while the dermal infiltrate is more mixed. As epidermal regeneration occurs, dermal fibrosis and new vessels with thickened walls can be found.


If the history points towards disease is a given organ system, it should be investigated. Blind screening is rarely helpful.


Systemic antihistamines usually with soporific action, or minor tranquilizers are generally the mainstay of therapy. Some feel that hydroxyzine is more effective than other antihistamines. Systemic corticosteroids usually produce little effect and the disease recurs rapidly. If internal disease is identified such as diabetes mellitus, it should be treated. Antimalarial agents and oral contraceptives have been used in the same manner.

Other measures: Both topical distracters and anesthetics such as polidocanol lotion or pramoxine can be tried. High potency corticosteroids can also be employed. The itching is so focal that some patients can be taught to use an antipruritic medication rather than destroying the lesion.

Just as for ordinary pruritus, radiation with UVB, UVA, and PUVA as well as PUVA bath therapy can be considered.

Other treatment options:

    Chinese/Indian herbs - This has helped a few people but not many. This only works if you change your diet. Cut out diary and processed foods. Only a qualified Chinese Herbal doctor will tell you this.

  • Colon Hydrotherapy - This is good to do whilst cleansing. This will help flush out all the toxins and any present parasites.

  • Chelation therapy - A heavy metal detox, which has been successful for some. Again, a change of diet is necessary during this process.

  • A raw low fat diet - juice your vegetables. Make green smoothies. Drink lots of water. Eat fruits, greens, vegetables, nuts and seeds. Make sure to balance out your intake. Do not eat too much of one thing.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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