The patient with prurigo nodularis were treated by needling at Bǎihuì（百会 GV 20）, Fēngchi（风池 GB 20）,Fēngfǔ（风府 GV 16）, Dàzhuī（大椎 GV 14）,Fēngmén（风门 BL 12）, Xīnshù（心俞 BL 1...The patient with prurigo nodularis were treated by needling at Bǎihuì（百会 GV 20）, Fēngchi（风池 GB 20）,Fēngfǔ（风府 GV 16）, Dàzhuī（大椎 GV 14）,Fēngmén（风门 BL 12）, Xīnshù（心俞 BL 15）, Gānshù（肝俞 BL18）, Qìhǎi（气海 CV 6）,Guānyuán（关元 CV 4）, Zhōngwǎn（中脘 CV12）, Xuèhǎi（血海 SP 10）, Zúsānlǐ（足三里ST 36）, Sānyīnjiāo（三阴交 SP 6）, Nèiting（内庭 ST 44）,Qūchí（曲池 LI 11）, Wàiguān（外关 TE 5） and Hégǔ（合谷 LI 4）. The treatment was given 4 times a week. After 2 weeks of treatment, the subjective pruritus was alleviated and tolerable. The patients could fall into sleep. After 2 months of treatment, no new skin rashes appear and pruritus disappeared basically, the old rashes started fading. The red color was getting pale and the bumpy rashes were absorbed. After 5 months of treatment, the itching symptoms were gone and skin rashes disappeared basically. The lesion skin was pigmented in dark grey. After 6 months of treatment, the dark grey pigmentation disappeared and skin was normal in color. The disease was not recurred in 1 year of follow-up.展开更多
BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administ...BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administration has approved,which leads to very variable practices in the prescription of off-label treatments.Treatment of PN is based on clinical experience rather than controlled trials.We present our case of generalized PN,in which we had a dramatic response with dupilumab.CASE SUMMARY A 58-year-old female patient was admitted to our clinic with severe itchy,erythematous nodular lesions that were widespread all over her body,especially on the legs and back.It was learned that the patient's complaints started 4 years ago,and there was a significant increase in the lesions in the last period.Dermatological examination revealed diffuse firm erythematous excoriated nodular lesions all over the body.In the blood tests of the patient,serum Immunoglobulin E(IgE)was measured at 9330 IU/mL.The patient was diagnosed with generalized prurigo nodularis together with clinical and histopathological findings.Due to severe clinical findings and the presence of comorbidities,dupilumab treatment was planned for the patient.In the follow-up 4 mo later,it was observed that all nodular lesions healed with postinflammatory hypopigmentation.The IgE value decreased to 1500 IU/mL after 4 mo of dupilumab treatment.CONCLUSION Dupilumab treatment stands out as an effective and safe systemic treatment agent among existing systemic treatments.展开更多
Prurigo nodularis(PN)is a chronic pruritic inflammatory skin disease characterized by hyperkeratotic papules and nodules symmetrically distributed on the back and extensor surfaces of the extremities,accompanied by se...Prurigo nodularis(PN)is a chronic pruritic inflammatory skin disease characterized by hyperkeratotic papules and nodules symmetrically distributed on the back and extensor surfaces of the extremities,accompanied by severe pruritus.PN has a serious impact on quality of life.[1–3]PN is a complex and difficult-to-treat condition.There is a lack of unified understanding of its diagnosis and treatment specifications,and the means approved for treating PN are limited;thus,clinicians mostly use empirical therapies.展开更多
Introduction:Pemphigoid nodularis is a rare clinical variant of bullous pemphigoid characterized by both prurigo nodularis-like lesions and pemphigoid-like blisters.Case presentation:A 72-year-old Chinese man has been...Introduction:Pemphigoid nodularis is a rare clinical variant of bullous pemphigoid characterized by both prurigo nodularis-like lesions and pemphigoid-like blisters.Case presentation:A 72-year-old Chinese man has been on follow-up at an outpatient Dermatology unit for extensive prurigo nodularis for past 4 to 5 years until an inpatient stay when he was admitted for labile mood and erratic behavior due to the intense pruritus and skin lesions.During the admission,the inpatient team noticed tense hemorrhagic blisters on his right thigh for which histological examination confirmed the diagnosis of bullous pemphigoid.He was treated with oral prednisolone,doxycycline,and nicotinamide,which led to clinical improvement.Discussion:Pemphigoid nodularis can be easily misdiagnosed as prurigo nodularis.We discuss clinical clues that can raise the suspicion of an underlying immunobullous disorder,including erythematous nodules with a much larger surface area affected by central erosions and ulceration.Pruritus associated with larger areas of erosions and ulceration is clues that lesions can be more than mere excoriations.Conclusion:It is important for clinicians to be aware of the presentation of prurigo nodularis in association with bullous pemphigoid such that effective treatment can be promptly instituted.This is especially illustrated in this case,as the treatment of bullous pemphigoid not only improved his skin condition but it also improved his psychological health and behavior with the resolution of itch.展开更多
Ultrasound energy liquefies high fluid content tissues, such as epidermis and sweat glands via cavitation, but minimally affects dermis, blood vessels, and nerves at the same energy level. We have used ultrasonic surg...Ultrasound energy liquefies high fluid content tissues, such as epidermis and sweat glands via cavitation, but minimally affects dermis, blood vessels, and nerves at the same energy level. We have used ultrasonic surgical aspirator to treat several skin diseases such as Bowen’s disease, wart, prurigo nodularis, and osmidrosis. The ultrasonic surgical aspirator offers an effective and safe method to treat them with few complications. We expect several other skin diseases could likely be cured using ultrasonic surgical aspirator by accumulating additional cases.展开更多
文摘The patient with prurigo nodularis were treated by needling at Bǎihuì（百会 GV 20）, Fēngchi（风池 GB 20）,Fēngfǔ（风府 GV 16）, Dàzhuī（大椎 GV 14）,Fēngmén（风门 BL 12）, Xīnshù（心俞 BL 15）, Gānshù（肝俞 BL18）, Qìhǎi（气海 CV 6）,Guānyuán（关元 CV 4）, Zhōngwǎn（中脘 CV12）, Xuèhǎi（血海 SP 10）, Zúsānlǐ（足三里ST 36）, Sānyīnjiāo（三阴交 SP 6）, Nèiting（内庭 ST 44）,Qūchí（曲池 LI 11）, Wàiguān（外关 TE 5） and Hégǔ（合谷 LI 4）. The treatment was given 4 times a week. After 2 weeks of treatment, the subjective pruritus was alleviated and tolerable. The patients could fall into sleep. After 2 months of treatment, no new skin rashes appear and pruritus disappeared basically, the old rashes started fading. The red color was getting pale and the bumpy rashes were absorbed. After 5 months of treatment, the itching symptoms were gone and skin rashes disappeared basically. The lesion skin was pigmented in dark grey. After 6 months of treatment, the dark grey pigmentation disappeared and skin was normal in color. The disease was not recurred in 1 year of follow-up.
文摘BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administration has approved,which leads to very variable practices in the prescription of off-label treatments.Treatment of PN is based on clinical experience rather than controlled trials.We present our case of generalized PN,in which we had a dramatic response with dupilumab.CASE SUMMARY A 58-year-old female patient was admitted to our clinic with severe itchy,erythematous nodular lesions that were widespread all over her body,especially on the legs and back.It was learned that the patient's complaints started 4 years ago,and there was a significant increase in the lesions in the last period.Dermatological examination revealed diffuse firm erythematous excoriated nodular lesions all over the body.In the blood tests of the patient,serum Immunoglobulin E(IgE)was measured at 9330 IU/mL.The patient was diagnosed with generalized prurigo nodularis together with clinical and histopathological findings.Due to severe clinical findings and the presence of comorbidities,dupilumab treatment was planned for the patient.In the follow-up 4 mo later,it was observed that all nodular lesions healed with postinflammatory hypopigmentation.The IgE value decreased to 1500 IU/mL after 4 mo of dupilumab treatment.CONCLUSION Dupilumab treatment stands out as an effective and safe systemic treatment agent among existing systemic treatments.
基金supported by a grant from the National Key Research and Development Programme of China(No.2023YFC2508200)
文摘Prurigo nodularis(PN)is a chronic pruritic inflammatory skin disease characterized by hyperkeratotic papules and nodules symmetrically distributed on the back and extensor surfaces of the extremities,accompanied by severe pruritus.PN has a serious impact on quality of life.[1–3]PN is a complex and difficult-to-treat condition.There is a lack of unified understanding of its diagnosis and treatment specifications,and the means approved for treating PN are limited;thus,clinicians mostly use empirical therapies.
文摘Introduction:Pemphigoid nodularis is a rare clinical variant of bullous pemphigoid characterized by both prurigo nodularis-like lesions and pemphigoid-like blisters.Case presentation:A 72-year-old Chinese man has been on follow-up at an outpatient Dermatology unit for extensive prurigo nodularis for past 4 to 5 years until an inpatient stay when he was admitted for labile mood and erratic behavior due to the intense pruritus and skin lesions.During the admission,the inpatient team noticed tense hemorrhagic blisters on his right thigh for which histological examination confirmed the diagnosis of bullous pemphigoid.He was treated with oral prednisolone,doxycycline,and nicotinamide,which led to clinical improvement.Discussion:Pemphigoid nodularis can be easily misdiagnosed as prurigo nodularis.We discuss clinical clues that can raise the suspicion of an underlying immunobullous disorder,including erythematous nodules with a much larger surface area affected by central erosions and ulceration.Pruritus associated with larger areas of erosions and ulceration is clues that lesions can be more than mere excoriations.Conclusion:It is important for clinicians to be aware of the presentation of prurigo nodularis in association with bullous pemphigoid such that effective treatment can be promptly instituted.This is especially illustrated in this case,as the treatment of bullous pemphigoid not only improved his skin condition but it also improved his psychological health and behavior with the resolution of itch.
文摘Ultrasound energy liquefies high fluid content tissues, such as epidermis and sweat glands via cavitation, but minimally affects dermis, blood vessels, and nerves at the same energy level. We have used ultrasonic surgical aspirator to treat several skin diseases such as Bowen’s disease, wart, prurigo nodularis, and osmidrosis. The ultrasonic surgical aspirator offers an effective and safe method to treat them with few complications. We expect several other skin diseases could likely be cured using ultrasonic surgical aspirator by accumulating additional cases.
