In simple words: Prurigo nodularis is a skin problem that causes very itchy bumps or lumps.These bumps are often hard and may get scratched raw because of the constant itching.It's a long-lasting condition, and treatment focuses on relieving the itching.

Prurigo nodularis (L28.1) is a chronic skin disorder manifesting as intensely pruritic (itchy), firm, hypertrophic papules and nodules. These lesions are often excoriated due to persistent scratching.The etiology is multifactorial, potentially involving genetic predisposition, psychological factors, and inflammatory processes.The lesions are typically found on the extremities, but can appear anywhere on the body.Diagnosis is primarily clinical, based on the characteristic presentation of intensely itchy nodules and a history of chronic scratching.Treatment options include topical corticosteroids, topical calcineurin inhibitors, antihistamines, and occasionally systemic therapies for severe cases.

Example 1: A 55-year-old female patient presents with multiple, intensely itchy, firm nodules on her forearms and legs for the past 2 years. She reports significant sleep disturbance due to pruritus.Diagnosis of Prurigo nodularis (L28.1) is made clinically.Treatment includes topical corticosteroids and an antihistamine., A 30-year-old male presents with hypertrophic, excoriated nodules on his elbows and knees, accompanied by a history of chronic scratching and associated anxiety.After physical examination, the diagnosis of L28.1 is established, and treatment includes topical corticosteroids, a referral to a psychologist for stress management, and an antihistamine., An 80-year-old patient exhibits multiple, intensely itchy, firm nodules on her back.These nodules have been present for 5 years and have resisted previous topical treatments.After ruling out other conditions, a diagnosis of L28.1 is established.Treatment involves a combination of higher potency topical corticosteroids and a referral to a dermatologist for consideration of systemic treatment.

Detailed history of the presenting symptoms (onset, duration, severity, location of lesions, associated factors), description of the physical findings (size, shape, color, distribution of lesions), results of relevant diagnostic tests if performed (skin biopsy if necessary to rule out other conditions), and treatment plan with response to therapy.

** The severity of Prurigo nodularis can range significantly.Treatment strategies should be tailored to the individual patient’s needs and response to treatment.Psychological factors often play a substantial role in the development and management of this condition.