Clinical Characteristics, Diagnostic Approaches, Therapeutic Management, and Associated Comorbidities of Prurigo Nodularis (Chronic Nodular Prurigo): An Observational Study in Clinical Practice in Spain

Abstract

Background: Prurigo nodularis/chronic nodular prurigo (PN/CNP) is a subtype of chronic prurigo characterized by pruritic nodules on the limbs and trunk. It predominantly affects older adults and women. The multifactorial etiology of PN/CNP complicates its diagnosis and treatment. This study aims to evaluate the clinical characteristics, diagnostic approaches, and patient burden of PN/CNP in Spain. Methods: This observational, cross-sectional, multicenter study was conducted across 12 Spanish hospitals and involved adult patients with PN/CNP. Data were collected from clinical records, patient interviews, and self-administered questionnaires. The study assessed clinical characteristics, diagnostic methods, treatments, and the burden of the disease. Descriptive statistics were used for analysis. Results: A total of 97 patients with PN/CNP were included, 65% of whom were female. The cohort had a mean age of 53 years. Most patients were White (87.5%) with Fitzpatrick phototype III (60.9%). Common comorbidities included dyslipidemia (36.1%), atopic dermatitis (33%), and anxiety/depression (30.9%). Topical treatments were used by 67% of patients, while systemic treatments were used by 63.9%. The average time to diagnosis was 4.5 years, and most patients reported mild to moderate pruritus and pain. Key therapeutic goals included reducing itch intensity (76.3%) and lesion count (37.1%). Overall, 66% of patients were satisfied with their treatment. Conclusion: This study provides a comprehensive profile of patients with PN/CNP in Spain, highlighting complex clinical characteristics and diverse treatment patterns. The findings emphasize the need for innovative, multidisciplinary approaches to the management of PN/CNP to improve patient care and guide future research.