Prurigo Nodularis

• Common Names: Prurigo Nodularis
• Medical Term: Lichen simplex chronicus (in some contexts due to overlapping features)

Summary

Prurigo nodularis is a chronic skin condition characterized by the presence of itchy nodules on the skin. It often leads to an intense cycle of itching and scratching, which can exacerbate the symptoms.

Causes

The exact cause of prurigo nodularis is not well understood, but it is believed to be linked to:

• Chronic itching and skin picking
• Inflammatory skin conditions
• Possible neurological factors

Risk Factors

Factors that may increase the risk include:

• Chronic skin diseases such as eczema or psoriasis
• Liver disease
• Emotional stress
• Certain neurological disorders

Symptoms

• Firm, itchy nodules on the arms, legs, or other areas of the body
• Intense itching
• Hypopigmented or hyperpigmented areas due to repeated scratching

Diagnosis

• Clinical examination based on the appearance of skin lesions
• Skin biopsy to rule out other conditions

Treatment Options

• Topical Treatments: Steroid creams and ointments to reduce inflammation.
• Oral Medications: Antihistamines to manage itching, and other systemic therapies like cyclosporine or thalidomide in severe cases.
• Phototherapy: UV light treatment to alleviate symptoms.

Prognosis and Follow-Up

• The condition can be chronic and requires ongoing management.
• Regular follow-ups with a dermatologist are essential to monitor response to treatment.

Complications

• Skin infections due to persistent scratching
• Scarring or permanent changes to the skin texture and color

Lifestyle & Prevention

• Avoid scratching to prevent aggravating the lesions.
• Use emollients or moisturizers to maintain skin hydration.
• Stress management techniques may help reduce flare-ups.

When to Seek Professional Help

• If intense itching affects daily activities or sleep
• Any signs of skin infection like increased redness, swelling, or pus

Additional Resources

• National Eczema Association (eczema.org)
• American Academy of Dermatology (aad.org)

Tips for Medical Coders

• Ensure accurate documentation of the diagnosis as L28.1 for prurigo nodularis in medical records.
• Be mindful of differentiating this condition from other similar dermatoses to avoid miscoding.