Chronic prurigo

Abstract

Chronic prurigo is a distinct disease defined by the presence of chronic pruritus for at least 6 weeks, a history and/or signs of repeated scratching, and multiple localized or generalized pruritic skin lesions (whitish or pinkish papules, nodules and/or plaques). Although chronic prurigo is frequently named prurigo nodularis, the nodular type of chronic prurigo is only the main clinical aspect of chronic prurigo. Chronic prurigo occurs due to neural sensitization to pruritus and the development of a vicious pruritus-scratching cycle. Chronic prurigo can be of allergological, dermatological, systemic, neurological, psychiatric/psychosomatic, mixed or undetermined origin. The prevalence is still debated. The burden is high. Current treatments often remained disappointing. Fortunately, recent research results on the pathophysiology of pruritus evidenced neuroimmune interactions and allow new therapeutic perspectives. Among them, antagonists of T-helper 2 cytokines, j-opioids and Janus kinase inhibitors may be promising.a Definition of pruriginous lesion: excoriated, scaling and/or crusted papules and/or nodules and/or plaques, often with a whitish or pink centre and hyperpigmented border.

Chronic prurigo: Insufficient disease control in spite of high healthcare usage

“…Dear Editor, Chronic prurigo (CPG) is a highly pruritic, debilitating disease, 1 complex to treat, 2 with an estimated prevalence of 8.4-210/100,000. 3 Patients are mostly treated by dermatologists and general practitioners, with 33.8% of patients receiving at least one systemic and 45.1% one topical prescription drug. 4 We investigated healthcare utilization and treatment patterns across Europe in a prospective, multicentre study.…”

“…The implementation of the recently published CPGspecific guideline 9 and the advent of modern therapies 3,10 will contribute to improve the care of CPG patients and reduce the strain on medical resources.…”

Efficacy and safety of vixarelimab, a human monoclonal oncostatin M receptor β antibody, in moderate-to-severe prurigo nodularis: a randomised, double-blind, placebo-controlled, phase 2a study

“… 7 , 8 , 9 A recent review article summarizes recent epidemiological studies estimating prevalence of chronic prurigo in various countries. 10 …”

Out‐of‐pocket expenditures in adult patients with prurigo nodularis in France

“…6 All these nosological discussions probably explain the large differences between studies trying to assess the prevalence, which is estimated to be between 8.4 and 210/100,000. 1,[7][8][9] European and US experts finally joined to build the "IFSI guideline on chronic prurigo including prurigo nodularis" and to consider that nodular type of chronic prurigo, prurigo nodularis and chronic nodular prurigo are synonyms and proposed guidelines for management. 10 According to these guidelines, psychological support and the use of emollients are recommended but are not reimbursed in France and other countries.…”