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.

结节性瘙痒是一种慢性皮肤病，在顽固性瘙痒症中涉及多个皮肤结节的发展。考虑到针对这种难以治疗的疾病的新兴治疗选择，目前需要对治疗方法进行综述。对临床研究进行了系统的综述，以调查从1990年至今的结节性瘙痒病治疗，包括≥5名受试者。根据牛津循证医学中心，总共为35篇文章分配了一定程度的证据。所有研究局部用药的5项研究，包括皮质类固醇，钙调神经磷酸酶抑制剂，钙泊三醇和辣椒素，均以2b或更高的证据水平传达了一些有益的作用。8个研究光化学疗法的报告中有6个达到了2b或更高的证据水平，并显示出良好的部分缓解率。有6份报告对沙利度胺进行了研究，这些报告提供了良好的症状反应证据，其中只有2份的等级为2b或更高。尽管有4级证据，但环孢霉素和甲氨蝶呤在4项联合研究中已证明获益。普瑞巴林，阿米替林，帕罗西汀，氟伏沙明和神经激肽-1受体拮抗剂已在5个2b级研究中显示出有希望的证据。为了评估结节性瘙痒症的安全有效的全身治疗方案，需要进行更高能力的研究和其他随机对照试验。尽管有4级证据，但环孢霉素和甲氨蝶呤在4项联合研究中已证明获益。普瑞巴林，阿米替林，帕罗西汀，氟伏沙明和神经激肽-1受体拮抗剂已在5个2b级研究中显示出有希望的证据。为了评估结节性瘙痒症的安全有效的全身治疗方案，需要进行更高能力的研究和其他随机对照试验。尽管有4级证据，但环孢霉素和甲氨蝶呤在4项联合研究中已证明获益。普瑞巴林，阿米替林，帕罗西汀，氟伏沙明和神经激肽-1受体拮抗剂已在5个2b级研究中显示出有希望的证据。为了评估结节性瘙痒症的安全有效的全身治疗方案，需要进行更高能力的研究和其他随机对照试验。