TO THE EDITOR Prurigo nodularis (PN) is a chronic dermatosis characterized by intensely pruritic, symmetrically distributed hyperkeratotic nodules. Although the cause of the disease is unknown, PN often develops in the context of systemic, dermatologic, and neuropsychiatric conditions (Boozalis et al., 2018;Iking et al., 2013;Winhoven and Gawkrodger, 2007). Despite this, limited data are available on the epidemiology of PN and burden of associated diseases (Boozalis et al., 2018;Iking et al., 2013). Here we estimate the prevalence of PN and the burden of associated conditions in a real-world, US population using a national claims database.Institutional review board approval was granted by the Johns Hopkins University School of Medicine. Data from the IBM MarketScan Commercial Claims and Encounters Database (IBM Watson Health) between October 2015 and December 2016 were analyzed, using standard codes based on the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). Adults with PN were defined as patients aged 18 to 64 years with 2 medical claims for PN (ICD-10-CM: L28.1) and continuous enrollment for 3 months before and after the index diagnosis (Supplementary Material). Three cohorts without PN were respectively identified for comparison: age-and sex-matched controls from the general population, patients with atopic dermatitis (AD), and patients with psoriasis. Patient demographics were recorded on the index date, with comorbidities selected based on associations with PN in previous literature and clinical experience

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