The term prurigo refers to intensely itchy spots. It may be used when the cause is known (see list below) or to describe a condition of unknown cause characterised by small itchy bumps.
Prurigo should be distinguished from pruritus (itch) in which there are no primary skin lesions.
Prurigo has primary and secondary skin lesions.
- Primary prurigo lesions are dome-shaped papules
- Secondary prurigo lesions are scratched papules, scaly lesions, or thickened, darkly pigmented areas (lichen simplex or neurodermatitis). Scratching may lead to scarring.
1. Prurigo simplex
Prurigo simplex presents as symmetrically distributed, small, intensely itchy, dome-shaped bumps. Sometimes there are tiny blisters. They are most numerous on the outer aspects of the limbs and buttocks, but may occur anywhere on head and neck, trunk and limbs. Prurigo may affect children or adults
Aternative names for prurigo simplex include chronic prurigo of adults, prurigo mitis, and Hebra prurigo. When the spots are dark in colour, it may be called prurigo pigmentosa.
Often the primary prurigo papule is no longer visible because scratching has removed it. Prurigo may cause considerable distress because severe itch can prevent sleep.
Emotional stress is a frequent trigger for prurigo.
2. Nodular prurigo
Nodular prurigo presents with hard warty nodules, often showing increased pigmentation. As they are very itchy, they are often ulcerated or crusted. Nodular prurigo is very resistant to treatment.
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