Prurigo Simplex or “Itchy Red Bump” Disease: Review and Case Series

Abstract

Prurigo simplex or “itchy red bump” disease is a controversial pruritic papular eruption. The objective of this study was to delineate the diagnostic criteria for this disease. A PubMed search was performed for: “prurigo simplex”, “prurigo simplex subacuta”, “subacute prurigo”, “chronic papular dermatitis in adults” and “itchy red bump disease”. Medical charts of patients with prurigo diagnoses in a university setting were analysed. The literature search revealed 32 relevant studies (431 patients) on different aspects of the disease. Out of 50 patients with prurigo diagnoses, 5 patients (4 women, mean age at onset 54 years) matched the description in literature. Small, severely itchy papules without secondary skin lesions continued to appear for years (mean 5.6 years). Skin biopsies revealed lymphocytic perivascular infiltrates, few eosinophils and occasionally spongiosis. Treatment with long-term methotrexate or cyclosporine cleared the symptoms. Some major and minor diagnostic criteria for prurigo simplex are proposed and compared with chronic prurigo.

The Neuronal Cotransmission: Mechanistic Insights From the Autonomic Nervous System

“…It has also currently been discovered that in some arteries of human beings that the vasoactive peptides, NPY with noradrenaline, are released from sympathetic nerves [ 42 ], while parasympathetic nerves secrete the vasoactive intestinal peptides (VIP), histamine isoleucine and acetylcholine [ 43 ]. Additionally, in the sensory nerves, calcitonin gene-related peptide (CGRP) is coreleased with the tachykinins [ 44 ]. These peptides seem to work like cotransmitters in both sympathetic as well as parasympathetic nerves, mainly at stimulation frequencies that are very high, with the stimulation in low frequencies releasing them from the sensory nerves [ 44 ].…”

“…Additionally, in the sensory nerves, calcitonin gene-related peptide (CGRP) is coreleased with the tachykinins [ 44 ]. These peptides seem to work like cotransmitters in both sympathetic as well as parasympathetic nerves, mainly at stimulation frequencies that are very high, with the stimulation in low frequencies releasing them from the sensory nerves [ 44 ].…”

Characterizing the Treatment of Papular Dermatitis: A Retrospective Chart Review

“…1 Biopsy shows spongiosis and a perivascular infiltrate of mononuclear cells with eosinophils. 1,2 The condition has many eponyms including “itchy red bump disease” and subacute prurigo. 1 Treatment consists of immunosuppressive agents aimed at controlling the inflammatory spongiotic disease.…”