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.