Prurigo – Overview

Prurigo is an extremely common skin condition that I encounter very frequently in both my The Woodlands dermatology and Conroe dermatology offices.  Also known as neurotic excoriations, Prurigo typically begins as an irritation in a small area of the skin.  These irritated areas are commonly called “hot spots.”  As a patient scratches or rubs this area, the skin may “break down” and form an ulcer or it can rise up and become very thick forming a lesion called a Prurigo nodule.  These Prurigo nodules are also referred to as Picker’s Nodules.  As the Prurigo nodules continue to be scratched the sensation of pruritus (itchyness) becomes worse and a patient may manipulate these lesions even more resulting in a cycle that continues the disease process.  Stress and depression have been linked to Prurigo.  Many patients may be left with scars after their Prurigo has resolved.  Treatment of Prurigo aims at breaking the itch scratch cycle.  Keeping the skin moisturized and healthy is very important in eliminating the sensations that can contribute to Prurigo.  Steroid creams are very helpful in reducing the size of Prurigo nodules as well as eliminating the sensation of pruritus.  Intralesional injections of a low dose steroid can also provide great benefit to many patients with this skin disease.