A Systematic Review of Systemic Medication for the Treatment of Prurigo Nodularis

Prurigo nodularis (PN) is an inflammatory skin disease marked by pruritic lesions requiring therapy to disrupt the scratch-itch cycle. This review assessed systemic treatments for PN efficacy through a comprehensive search, yielding 88 relevant studies. Dupilumab proved effective with reduced side effects, alleviating pruritus and lesion appearance. Thalidomide and pregabalin showed efficacy but pose limitations due to muscle and nerve pain during prolonged use. Janus Kinase inhibitors may be promising, but extensive population studies still need to be included. The findings highlight the importance of a multimodal approach, targeting both immune and neural aspects in PN treatment.