Introduction:
Prurigo nodularis (PN) is a cutaneous condition of unknown etiology postulated as a nodular presentation of lichen simplex chronicus [1]. The estimated incidence and prevalence are 0.003% and 0.033%, respectively [2]. PN presents as multiple erythematous, dome-shaped lesions 1-2 cm in diameter, commonly on the extensor extremities [1]. PN is often treatement resistant and requires prolonged regimens. Therapy aims to decrease inflammation and pruritus using corticosteroids, vitamin D analogs, calcineurin inhibitors, antihistamines, opiate antagonists, immunomodulators, and neuromodulators [1]. More recently, monoclonal antibodies have shown utility in treating PN [3,4]. These are often expensive and inaccessible for all patients. This case details widespread, refractory prurigo nodularis successfully treated with a combined regimen of UVB phototherapy, cryotherapy, and intralesional corticosteroids. This regimen is effective, safe, easily accessible, and affordable.