Oral Alitretinoin for Patients with Refractory Prurigo

Abstract

Background: prurigo is a chronic skin disorder associated with a history of chronic pruritus. The pathogenesis of prurigo is largely unknown and the treatment of prurigo is unsatisfactory and challenging. Conventional systemic treatments may be beneficial; however, their possible side effects and possible transient efficacy is still a problem. We aimed to present the clinical course and effect of treatment with alitretinoin on patients with prurigo nodularis initially treated with conventional treatments like oral antihistamine, cyclosporine, and phototherapy. Methods: all the patients had prurigo nodularis refractory to conventional treatment. Their medical records included demographic features, past medical history, duration of disease, and treatment modalities; and the clinical courses of the patients were reviewed for this retrospective study. We evaluated patient pruritus and skin lesions for the duration. Results: we present reports involving 10 patients with refractory prurigo. All the patients in our cases were treated with oral alitretinoin after previous treatments and reported the improvement of skin lesions and pruritus within 2 weeks to 3 months. Conclusions: we suggest that oral alitretinoin may be an effective and well tolerated treatment option for patients with intractable prurigo. Further clinical studies are warranted to confirm the long-lasting efficacy and safety of alitretinoin for treating patients with prurigo.

Prurigo Nodularis: Moving Forward

“…Recent case reports and case series have found the vitamin A derivative alitretinoin to be an effective treatment for recalcitrant PN, typically at a dosage of 30 mg daily. 12,13 Sustained remission was noted even after discontinuation of the medication. 12 Alitretinoin, which has been demonstrated to be effective in treating dermatitis, 14 was well tolerated.…”

“…12,13 Sustained remission was noted even after discontinuation of the medication. 12 Alitretinoin, which has been demonstrated to be effective in treating dermatitis, 14 was well tolerated. Similar to JAK inhibitors, there are minimal data investigating the use of topical retinoids in the treatment of localized PN.…”

Chronic prurigo

“…No meta‐analysis was performed. After this systematic review, some case series suggest that oral alitretinoin alone 64 or in association with methotrexate 65 could be effective, and a pilot study of 10 patients showed that a 12‐week treatment with apremilast was ineffective 66 . Papers with a very high level of evidence were also published (see Therapeutic perspectives).…”