Redrawing the Map in Prurigo Nodularis: From Conventional Approaches to Targeted Biologics

IF 1 4区医学 Q1 DERMATOLOGY

Dermatologic Therapy Pub Date : 2026-08-12 DOI:10.1155/dth/1342428

Göknur Kalkan

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引用次数: 0

Abstract

Background

Prurigo nodularis (PN) is a chronic, neuroimmune-mediated dermatosis characterized by intense pruritus and nodular lesions that severely impair patient quality of life. The limitations of conventional therapies in providing more than symptomatic relief have necessitated novel approaches targeting the disease’s heterogeneous pathogenesis.

Objective

This review evaluates current treatment algorithms and the potential future clinical frameworks tailored to the immunological and neuropathic endotypes of PN.

Methods

A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, and Google Scholar databases for English-language peer-reviewed articles, clinical trials, and guidelines published up to December 2025, focusing on targeted and conventional therapies for prurigo nodularis.

Results

In addition to approved biologics such as the IL-4/IL-13 pathway inhibitor dupilumab and the IL-31 receptor antagonist nemolizumab, this review discusses emerging options, including JAK inhibitors, mast cell–targeted therapies, and opioid modulators. Current evidence suggests that these targeted agents offer significant improvements in both pruritus and lesion resolution by addressing specific molecular drivers.

Conclusion

The management of PN is entering a transitional phase, with an emerging goal to evolve from uniform approaches toward future biomarker- and phenotype-based, disease-modifying, and personalized strategies. Defining these endotypes more precisely will be essential for optimizing potential therapeutic individualization and long-term clinical success.

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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.