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How to manage prurigo nodularis?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

Prurigo nodularis is making my life hell! I got diagnosed six months ago, but I probably had it longer. These itchy nodules are everywhere, such as arms, legs, back, and even my neck now! They are like hard little domes that itch so bad I scratch until they bleed. I tried prescription creams, antihistamines, and I even wrapped my arms at night to stop scratching. Nothing works! My skin looks terrible with all these scars and dark spots. Read about some injection medicine online - something about interleukin (IL)-31? Is that worth trying? My regular doctor seems out of ideas. Could this be connected to my thyroid problems? Please help me understand what is causing this torture.

Kindly help.

Answered by Dr. Sally Attalah

Education:

BDS

Professional Bio:

Dr. Sally Attalah is an experienced Dental Surgeon with a Bachelor of Dental Surgery earned in 2007, followed by her internship in 2008. She has been an affiliate member of the American Dental Association since 2015, reflecting her commitment to maintaining global standards in dental care. Dr. Sally is dedicated to providing high-quality oral healthcare with a patient-focused approach.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Interleukin (IL)-31 is a neuroimmune cytokine that drives the most burdensome symptom in prurigo nodularis and atopic dermatitis, namely itch, and is also involved in skin inflammation and keratinocyte abnormalities.

Injection Nemolizumab, an mAb (monoclonal antibody) that targets the IL-31 receptor alpha subunit, has shown substantial efficacy in reducing pruritus and improving skin lesions in patients with prurigo nodularis (PN). Clinical trials demonstrate rapid and sustained improvements in itch severity.

Low thyroid levels can generally be seen within two to three months of starting immunotherapy treatment.

The probable cause includes:

Prurigo nodularis.

I advise you to do the following:

Nemolizumab injection is to be taken. It targets the IL-31 alpha subunit.

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

I hope this helps.

Thank you.

Medically reviewed by iCliniq medical review team
Published At June 5, 2025
Reviewed At June 3, 2026

Education:

BDS

Professional Bio:

Dr. Sally Attalah is an experienced Dental Surgeon with a Bachelor of Dental Surgery earned in 2007, followed by her internship in 2008. She has been an affiliate member of the American Dental Association since 2015, reflecting her commitment to maintaining global standards in dental care. Dr. Sally is dedicated to providing high-quality oral healthcare with a patient-focused approach.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

BDS

Professional Bio:

Dr. Sally Attalah is an experienced Dental Surgeon with a Bachelor of Dental Surgery earned in 2007, followed by her internship in 2008. She has been an affiliate member of the American Dental Association since 2015, reflecting her commitment to maintaining global standards in dental care. Dr. Sally is dedicated to providing high-quality oral healthcare with a patient-focused approach.

This doctor is not available for online consultations on the platform anymore.

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