Which therapy is better for prurigo nodularis?

Question

Hello doctor,

I have been dealing with prurigo nodularis for way too long, and nothing seems to work. The itching is driving me crazy, and these nodules keep getting worse. My dermatologist mentioned trying cryotherapy or phototherapy. Which one helps more? I read that cryotherapy can be painful, but does it reduce the bumps faster? On the other hand, is phototherapy safe in the long term? I do not want to waste more time on stuff that barely helps. Do these treatments stop new nodules from forming?

Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I am sorry to hear that you are struggling with prurigo nodularis. Both cryotherapy and phototherapy are effective treatments. In doing cryotherapy, the response is faster, and it can flatten the lesions, and the symptoms are reduced. But they are not good for widespread lesions, cannot stop lesions from coming, and painful side effects like blistering, scarring, or depigmentation can be experienced. Phototherapy is good for large numbers of lesions and can prevent new ones. But phototherapy is long-term, safety is debatable, and it requires multiple sessions. The other treatment options available are topical steroids, intralesional steroids (three weekly injections over individual lesions), excimer laser (considered safe as compared to phototherapy), and biologic therapy (if resistant and recalcitrant disease).

I hope this helps.

Thank you, and take care.