Clinical, Histopathological, and Direct Immunofluorescence Characteristics of Prurigo-Nodularis-Like Lesions and Pruritus: A Retrospective Study of Patients Admitted to a Tertiary Dermatology Hospital

IF 3.4 4区医学 Q1 DERMATOLOGY

Dermatologic Therapy Pub Date : 2025-08-02 DOI:10.1155/dth/6375115

Sajedeh Rezaeemanesh, Mehrdad Fathikazerouni, Nasim Tootoonchi, Alireza Ghanadan, Seyed Mohammad Vahabi, Sahar Montazeri, Huria Memari, Ifa Etesami

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Abstract

Background: Prurigo nodularis (PN) is a chronic skin condition characterized by intensely itchy nodules. Accurate identification and treatment of PN-like lesions are crucial due to their association with various dermatoses. Direct immunofluorescence (DIF) assays play a significant role in distinguishing PN from similar conditions.

Methods: We conducted a retrospective analysis on patients referred to a tertiary dermatology hospital between 2017 and 2022. These patients presented with pruritus and PN-like lesions and underwent skin biopsies. PN diagnosis relied on clinical evidence, laboratory results, and histopathology, ruling out other differentials. Collected data included demographics, clinical manifestations, histology, and final diagnoses. Statistical analysis employed SPSS Version 26, using mean, standard deviation, frequency, and percentage. Significance was set at p < 0.05.

Results: Our study included 746 individuals (mean age 45.34 ± 22.05; 423 females and 323 males) with pruritus and PN-like lesions. Clinical evidence and laboratory findings established final diagnoses: PN (51.1%), dermatitis (17.6%), lichen planus (8.4%), perforating disease (7.0%), and bite reaction (3.1%). DIF assays were performed on 177 patients, with 26 (19.2%) yielding positive results. Bullous pemphigoid (50%) and dermatitis herpetiformis (11.5%) were the most common diagnoses.

Conclusion: Our study emphasizes the need for comprehensive diagnostic approaches, including DIF, to accurately diagnose PN-related conditions. The high PN confirmation rate validates initial clinical suspicion and expert judgment. Considering the potential confusion with dermatitis and immunobullous disorders, targeted health policies and resource allocation are essential for improved diagnostic capabilities and treatment outcomes in patients with PN-like lesions.

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痒疹-结节样病变和瘙痒症的临床、组织病理学和直接免疫荧光特征：对三级皮肤科医院住院患者的回顾性研究

背景：结节性痒疹（PN）是一种以结节强烈瘙痒为特征的慢性皮肤病。准确识别和治疗pn样病变是至关重要的，因为它们与各种皮肤病有关。直接免疫荧光（DIF）检测在区分PN和类似情况下发挥重要作用。方法：回顾性分析2017 - 2022年在某三级皮肤科医院转诊的患者。这些患者表现为瘙痒和pn样病变，并接受皮肤活检。PN诊断依赖于临床证据、实验室结果和组织病理学，排除其他鉴别。收集的资料包括人口统计学、临床表现、组织学和最终诊断。统计分析采用SPSS Version 26，采用均值、标准差、频率、百分比。p <为显著性；0.05. 结果：本研究纳入746例患者(平均年龄45.34±22.05；423名女性和323名男性)伴有瘙痒和pn样病变。临床证据和实验室结果确定了最终诊断：PN（51.1%）、皮炎（17.6%）、扁平苔藓（8.4%）、穿孔病（7.0%）和咬伤反应（3.1%）。对177例患者进行DIF检测，26例（19.2%）阳性。大疱性类天疱疮（50%）和疱疹样皮炎（11.5%）是最常见的诊断。结论：我们的研究强调需要综合诊断方法，包括DIF，以准确诊断pn相关疾病。高PN确诊率证实了最初的临床怀疑和专家判断。考虑到皮炎和免疫大泡性疾病的潜在混淆，有针对性的卫生政策和资源分配对于提高pn样病变患者的诊断能力和治疗效果至关重要。

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来源期刊

Dermatologic Therapy 医学-皮肤病学

CiteScore

7.00

自引率

8.30%

发文量

711

审稿时长

3 months

期刊介绍： Dermatologic Therapy has been created to fill an important void in the dermatologic literature: the lack of a readily available source of up-to-date information on the treatment of specific cutaneous diseases and the practical application of specific treatment modalities. Each issue of the journal consists of a series of scholarly review articles written by leaders in dermatology in which they describe, in very specific terms, how they treat particular cutaneous diseases and how they use specific therapeutic agents. The information contained in each issue is so practical and detailed that the reader should be able to directly apply various treatment approaches to daily clinical situations. Because of the specific and practical nature of this publication, Dermatologic Therapy not only serves as a readily available resource for the day-to-day treatment of patients, but also as an evolving therapeutic textbook for the treatment of dermatologic diseases.