Current clinical practice of prurigo nodularis in Japan: A cross-sectional web-survey among dermatologists.

Hiroyuki Murota, Mai Matsumoto, Kazuhiko Arima, Takuo Yoshida, Hiroyuki Fujita
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Abstract

Prurigo nodularis (PN) is a chronic inflammatory skin disease associated with intense pruritic nodules. The unclear patho-etiological mechanisms of PN cause difficulty in disease management; and there is a paucity of information on the current diagnosis and treatment options for PN in Japan. To describe the current management from a dermatologists' perspective we conducted a web-based survey (UMIN Clinical Trial Registry UMIN000047643) in 2022 among dermatologists from a Japanese commercially available physician panel, who had seen at least one patient with PN within the last 3 months. The survey included 117 dermatologists. The dermatologists diagnosed PN mainly by confirming clinical signs and patient interviews, while to assess the severity of PN, the number of pruritic nodules and the degree of itching were primarily utilized. Topical corticosteroids and antihistamines were the most used drugs, as recommended in the current guidelines on the diagnosis and treatment of prurigo. Dermatologists' treatment satisfaction decreased with increasing assumed severity of PN; almost 65% dermatologists were not satisfied with the treatment of severe PN. These results suggest the need of more effective medications and diagnostic tools for better management of PN in Japan.

日本结节性瘙痒症的临床实践现状:对皮肤科医生的横断面网络调查。
结节性瘙痒症(PN)是一种伴有剧烈瘙痒性结节的慢性炎症性皮肤病。结节性瘙痒症的病理病因机制不明确,给疾病的治疗带来困难;在日本,有关结节性瘙痒症的现有诊断和治疗方案的信息很少。为了从皮肤科医生的角度描述目前的治疗方法,我们于 2022 年对日本商业化医生小组中的皮肤科医生进行了一项网络调查(UMIN 临床试验注册 UMIN000047643),这些医生在过去 3 个月内至少接诊过一名 PN 患者。调查对象包括 117 名皮肤科医生。皮肤科医生主要通过确认临床症状和访谈患者来诊断 PN,而评估 PN 的严重程度则主要采用瘙痒性结节的数量和瘙痒程度。根据现行瘙痒症诊断和治疗指南的建议,外用皮质类固醇激素和抗组胺药是最常用的药物。皮肤科医生的治疗满意度随着瘙痒症假定严重程度的增加而降低;近 65% 的皮肤科医生对严重瘙痒症的治疗不满意。这些结果表明,日本需要更有效的药物和诊断工具来更好地治疗 PN。
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