Are biologics safe for multiple autoimmune conditions?

Question

Hello doctor,

I am a 42-year-old female recently diagnosed with prurigo nodularis after years of experiencing intensely itchy, thickened skin nodules. I also have Hashimoto’s thyroiditis and fibromyalgia. My dermatologist mentioned that my immune system might be overactive, potentially contributing to this condition. Could my autoimmune disorders be exacerbating my prurigo nodularis?

Are biologics like Dupixent a suitable option for someone with multiple autoimmune conditions? Additionally, are there any specific dietary or lifestyle changes that could help reduce flare-ups?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Prurigo nodularis (PN) is a chronic neuroimmune skin disorder characterized by the presence of hard, extremely itchy nodules. While the exact cause of PN remains unknown, these nodules develop due to persistent, intense scratching and rubbing of the skin. Neural sensitization of itch in PN is also strongly associated with other pain-related neural sensitization disorders, such as fibromyalgia.

FDA-approved treatment for PN: Dupixent (Dupilumab) has been approved by the FDA as the first and only treatment specifically indicated for prurigo nodularis.

Lifestyle tips for managing prurigo nodularis

Make scratching difficult – Keep your fingernails short, and consider wearing soft gloves to bed.
Cover your skin – Wear long-sleeved shirts and pants made from soft, comfortable fabrics.
Be gentle with your skin in the shower – Use mild cleansers and lukewarm water.
Moisturize regularly – Keep your skin hydrated to help reduce irritation.
Try an antihistamine, which may help control itching and allergic reactions.
Practice self-care – Stress management techniques, such as mindfulness and relaxation exercises, can help reduce flare-ups.

Dietary considerations: Avoiding processed foods is an important step in managing PN symptoms.

Sugary foods – High sugar intake can contribute to inflammation and immune system dysfunction. Reducing the consumption of candies, pastries, and sugary drinks may help manage symptoms.
Foods to avoid – Red meat, processed foods with high levels of additives and preservatives, trans fats, fried foods, refined sugars, and flour.

Probable causes of PN: Chronic neuroimmune skin disorder

Treatment options: The standard treatment for PN includes:

Corticosteroids.
Antihistamines.
Phototherapy.

However, these treatments often provide only partial or temporary relief. For refractory cases, immunomodulatory drugs such as Thalidomide and Lenalidomide have been used successfully.

Preventive measures

Maintain a healthy, anti-inflammatory diet.
Avoid known irritants and allergens.
Follow a consistent skincare routine.

I hope this information helps you.

Please let us know if you have any further queries.

Thank you.