At 36, can stress trigger my prurigo nodularis?

Question

Hello, Doctor,

I really need help with these crazy, itchy bumps on my thighs and legs. I am 36 years old, female, and I have been there for almost a year. These are hard, dark nodules that itch all day, worse at night. I can not sleep, and can not wear skirts. So I have stopped going out.

Doctors said it is prurigo nodularis. He gave steroid creams and antihistamines, but they barely helped. I scratch in my sleep without realizing. Please tell me,

Is this autoimmune?
Could stress be triggering it?
Is there any long-term treatment that works, like injections or light therapy?
Is Dupixent safe for this?
Will the marks ever go away?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Prurigo Nodularis chronic skin condition with extremely itchy, hard, dome-shaped nodules that often start with intense scratching. Your condition seems to have nerve and immune system involvement, both of which contribute to the persistent itching and inflammation. Your immune system plays a critical role in this condition.

It occurs when your nerve endings are sending intense, constant itch signals even without real triggering factors. This creates inflammation, leading to more itching, scratching, and nodule formation, which becomes a vicious cycle as itching to scratching to bump, or nodule..

Triggering factors could be injury, dermatitis, eczema, or stress. If you can control some of these factors,

You can take the following advice,

Dupilumab (a monoclonal antibody) controls itching and inflammation. Its side effects could be irritation in the eyes, swelling, and redness at the injection site.
Nemolizumab (a humanized monoclonal antibody) controls itching.
Gabapentin or Pregabalin (an anticonvulsant ) is used for nerve-related itch and nighttime scratching.
Narrowband UVB phototherapy is safe and effective for many people with widespread symptoms.
Topical steroids, calcineurin inhibitors (like Tacrolimus), or capsaicin cream are given with other drugs
Oral immunosuppressants like Cyclosporine and Methotrexate are used in severe cases but have more side effects.

I hope this information helps you.

Feel free to ask further queries.

Thank you.