Médecine

Paramédical

Autres domaines


S'abonner

A systematic review of evidence-based treatments for prurigo nodularis - 11/02/19

Doi : 10.1016/j.jaad.2018.09.020 
Azam A. Qureshi, BA a, Laura E. Abate, MSLS b, Gil Yosipovitch, MD c, Adam J. Friedman, MD a, d,
a Department of Dermatology, George Washington Medical Faculty Associates, Washington, DC 
b Himmelfarb Health Sciences Library, George Washington University, Washington, DC 
c Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida 
d Department of Dermatology, George Washington School of Medicine and Health Sciences, George Washington University, Washington, DC 

Reprint requests: Adam J. Friedman, MD, Department of Dermatology, George Washington School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Ste 2B-427, Washington, DC 20037.Department of DermatologyGeorge Washington School of Medicine and Health Sciences2150 Pennsylvania AveNW, Ste 2B-427WashingtonDC20037

Abstract

Prurigo nodularis is a chronic dermatologic condition involving the development of multiple cutaneous nodules in the setting of intractable pruritus. Given emerging treatment options for this difficult-to-treat condition, a current review of therapeutics is needed. A systematic review was performed for clinical studies investigating prurigo nodularis treatment published from 1990 to present including ≥5 subjects. A total of 35 articles were assigned a level of evidence according to the Oxford Center for Evidence-based Medicine. All 5 studies investigating topical agents, including corticosteroids, calcineurin inhibitors, calcipotriol, and capsaicin, conveyed some beneficial effect with level of evidence 2b or higher. Six of 8 reports investigating photo- and photochemotherapy achieved levels of evidence 2b or greater and showed good partial response rates. Thalidomide was studied by 6 reports providing evidence of good symptom response, only 2 of which were rated level 2b or greater. Cyclosporine and methotrexate have demonstrated benefit in 4 combined studies, albeit with level 4 evidence. Pregabalin, amitriptyline, paroxetine, fluvoxamine, and neurokinin-1 receptor antagonists have demonstrated promising evidence in 5 level 2b studies. Higher-powered studies and additional randomized controlled trials are needed for the evaluation of safe and efficacious systemic treatment options for prurigo nodularis.

Le texte complet de cet article est disponible en PDF.

Key words : chronic pruritus, nodular prurigo, prurigo nodularis

Abbreviations used : CGRP, IL, LOE, MC, MTX, NRS, PN, PUVA, RCT, VAS


Plan


 Funding sources: None.
 Dr Friedman has received honoraria for participation in advisory boards for Menlo Therapeutics, Inc, and serves as an investigator for Kiniksa Pharmaceuticals. Dr Yosipovitch has received honoraria for participation in advisory boards for Menlo Therapeutics, Inc, Trevi, Sienna, Galderma, Novartis, OPKO Health, Inc, Pfizer, Sanofi, and UCB. He has received grant/research support for his role as an investigator from Menlo Therapeutics, Inc, Galderma, Vanda Pharmaceuticals, Kiniksa Pharmaceuticals, Sun Pharma, and Pfizer.


© 2018  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 80 - N° 3

P. 756-764 - mars 2019 Retour au numéro
Article précédent Article précédent
  • Clear cell acanthoma (CCA)-like lesions of the nipple/areola: A clinicopathological study of 12 cases supporting a nonneoplastic eczematous disease
  • Kang-Ling Kuo, Chi-Shou Lo, Li-yu Lee, Chih-Hsun Yang, Tseng-tong Kuo
| Article suivant Article suivant
  • Present and future perspectives of photodynamic therapy for cutaneous squamous cell carcinoma
  • Uma Keyal, Anil Kumar Bhatta, Guolong Zhang, Xiu Li Wang

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.