Table of ContentsView AllTable of ContentsPN and CancerCancer ScreeningPN CausesRisk FactorsTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
PN and Cancer
Cancer Screening
PN Causes
Risk Factors
Treatment
Frequently Asked Questions
Everyone’s had an itch they just needed to scratch. But in some cases, these itches are extreme and can lead to the development of large bumps calledprurigo nodularis.
PN is associated with a variety of skin diseases and systemic diseases, including atopic dermatitis, contact dermatitis, diabetes, end-stage kidney disease, hepatitis C, and untreated HIV.It has also been linked to some cancers and cancer treatments.
This article will explain prurigo nodularis and explore the link between prurigo nodularis and cancer.
Natthawat / Getty Images
The Link Between PN and Cancer
Some cases of PN appear when a person gets an underlying disorder that causes itching, stinging, or burning sensations. Prurigo nodularis is associated with a variety of conditions and, less commonly, with cancer.There are a few links between prurigo nodularis and cancer to explore.
The American Academy of Dermatology notes having lymphoma (cancer of the lymphatic system) may increase the risk of PN.
A study of 695 people with PN ages 40 to 69 found 18% had a malignancy. These cancers were most often skin cancer, blood cancer, gynecologic cancer, breast cancer, gastrointestinal cancer, or lung cancer.In this study, people with PN were over four times more likely to have cancer than people without the condition.
Cancer Screening of People With PN
All people with PN should ensure they’re getting theregular cancer screeningsappropriate for their age, considering their other risk factors.
If you have PN, it may be important to rule out certain underlying diseases that may be causing the itching and leading to the development of nodules. For this reason, your healthcare provider may suggest getting blood tests to determine if these conditions are present.
Blood tests may include:
Depending on your medical history and physical examination, healthcare providers may also take a skin biopsy (removing a sample to be analyzed in the lab). They also may order imaging studies such as X-rays, computed tomography (CT), or magnetic resonance imaging (MRI).
Prurigo Nodularis Causes
In many ways, PN is still a mystery. It can appear on its own or be associated with one of the many other diseases it has been linked to.
Its cause is unknown. It seems to be linked to disruption of the immune system and possibly also the nerves that are in the skin. The nerves cause increased itchy sensations and lead to scratching and picking, which further causes the development of nodules on the skin.
The nodules are typically absent on areas of the skin like the back, where people can’t reach—causing a butterfly pattern.
Prurigo Nodularis Risk Factors
PN seems to occur more often in people who are:
It is also possible that medications can lead to PN. Itchiness and PN have been reported as a reaction to chemotherapy agents paclitaxel and carboplatin and the immunotherapy drug Keytruda (pembrolizumab). These medications may lead to prolonged activation of the immune system that may lead to PN.
In the United States, studies estimate 72 new cases of PN for every 100,000 people between the ages of 18 and 64 years old.A study at the Johns Hopkins Health System found it was 3.4 times more common in Black Americans than in White Americans.
People with PN had an increased likelihood of:
These diseases are linked to an increased likelihood of having PN, but that doesn’t mean they cause PN. These conditions could lead to PN, but it could also be that mental and physical health declines in patients with PN. Or there could be no specific connection and the correlation could be due to outside factors.
Other options include anti-inflammatory medications and those that can alter the immune response. These treatments don’t always work. Sometimes the discovery and treatment of an underlying condition will help clear up the itching and PN.
People with prurigo nodularis may developneuropathy, which is nerve pain.
Some PN treatments that healthcare providers may try include:
If medications can’t stop the itching, behavioral treatments may help reduce scratching. People with PN should:
Being itchy all the time can also mess with your mental health. Sometimes, healthcare providers will prescribe antidepressants; Neurontin (gabapentin), an antiseizure drug that also treats nerve pain; or sedatives to help with sleep and night-time itching.
Summary
Prurigo nodularis (PN) is a chronic inflammatory skin disease that causes itching and bumps across the arms, legs, and chest. Many times, there is an underlying disease that leads to itching. This can be any of a variety of conditions, and less often it might be attributed to cancer, such as lymphoma.
Cancer treatments can also lead to prurigo nodularis. People with PN should ask their healthcare provider if they need additional screenings to rule out underlying diseases.
Frequently Asked QuestionsYour healthcare provider will likely try a variety of creams, pills, and other treatments to help reduce the itchiness of your prurigo nodularis (PN). These may include antihistamines, anti-inflammatories, physical barriers, and other treatments. In some cases, identifying and treating an underlying condition can improve PN symptoms.Many treatments have been used for prurigo nodularis (PN). In some cases, PN resolves using these treatments. In others, it will resolve if the underlying cause is treated. Sometimes, it does not get better.One study found that cancers are more than 4 times more likely in people with prurigo nodularis.
Your healthcare provider will likely try a variety of creams, pills, and other treatments to help reduce the itchiness of your prurigo nodularis (PN). These may include antihistamines, anti-inflammatories, physical barriers, and other treatments. In some cases, identifying and treating an underlying condition can improve PN symptoms.
Many treatments have been used for prurigo nodularis (PN). In some cases, PN resolves using these treatments. In others, it will resolve if the underlying cause is treated. Sometimes, it does not get better.
One study found that cancers are more than 4 times more likely in people with prurigo nodularis.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Prurigo nodularis: causes.Kwon CD, Khanna R, Williams KA, Kwatra MM, Kwatra SG.Diagnostic workup and evaluation of patients with prurigo nodularis.Medicines (Basel). 2019;6(4):97. doi:10.3390/medicines6040097Larson VA, Tang O, Stander S, Miller LS, Kang S, Kwatra SG.Association between prurigo nodularis and malignancy in middle-aged adults.J Am Acad Dermatol. 2019;81(5):1198-1201. doi:10.1016/j.jaad.2019.03.083Huang AH, Canner JK, Khanna R, Kang S, Kwatra SG.Real-world prevalence of prurigo nodularis and burden of associated diseases.J Invest Dermatol. 2020;140(2):480-483.e4. doi:10.1016/j.jid.2019.07.697Boozalis E, Tang O, Patel S, et al.Ethnic differences and comorbidities of 909 prurigo nodularis patients.J Am Acad Dermatol. 2018;79(4):714-719.e3. doi:10.1016/j.jaad.2018.04.047National Organization for Rare Disorders.Prurigo nodularis.Hughes JM, Woo TE, Belzberg M, et al.Association between prurigo nodularis and etiologies of peripheral neuropathy: suggesting a role for neural dysregulation in pathogenesis.Medicines (Basel). 2020;7(1):4. doi:10.3390/medicines7010004Additional ReadingNational Organization for Rare Disorders (2021).Prurigo Nodularis - NORD (National Organization for Rare Disorders)
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Prurigo nodularis: causes.Kwon CD, Khanna R, Williams KA, Kwatra MM, Kwatra SG.Diagnostic workup and evaluation of patients with prurigo nodularis.Medicines (Basel). 2019;6(4):97. doi:10.3390/medicines6040097Larson VA, Tang O, Stander S, Miller LS, Kang S, Kwatra SG.Association between prurigo nodularis and malignancy in middle-aged adults.J Am Acad Dermatol. 2019;81(5):1198-1201. doi:10.1016/j.jaad.2019.03.083Huang AH, Canner JK, Khanna R, Kang S, Kwatra SG.Real-world prevalence of prurigo nodularis and burden of associated diseases.J Invest Dermatol. 2020;140(2):480-483.e4. doi:10.1016/j.jid.2019.07.697Boozalis E, Tang O, Patel S, et al.Ethnic differences and comorbidities of 909 prurigo nodularis patients.J Am Acad Dermatol. 2018;79(4):714-719.e3. doi:10.1016/j.jaad.2018.04.047National Organization for Rare Disorders.Prurigo nodularis.Hughes JM, Woo TE, Belzberg M, et al.Association between prurigo nodularis and etiologies of peripheral neuropathy: suggesting a role for neural dysregulation in pathogenesis.Medicines (Basel). 2020;7(1):4. doi:10.3390/medicines7010004Additional ReadingNational Organization for Rare Disorders (2021).Prurigo Nodularis - NORD (National Organization for Rare Disorders)
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Dermatology Association.Prurigo nodularis: causes.Kwon CD, Khanna R, Williams KA, Kwatra MM, Kwatra SG.Diagnostic workup and evaluation of patients with prurigo nodularis.Medicines (Basel). 2019;6(4):97. doi:10.3390/medicines6040097Larson VA, Tang O, Stander S, Miller LS, Kang S, Kwatra SG.Association between prurigo nodularis and malignancy in middle-aged adults.J Am Acad Dermatol. 2019;81(5):1198-1201. doi:10.1016/j.jaad.2019.03.083Huang AH, Canner JK, Khanna R, Kang S, Kwatra SG.Real-world prevalence of prurigo nodularis and burden of associated diseases.J Invest Dermatol. 2020;140(2):480-483.e4. doi:10.1016/j.jid.2019.07.697Boozalis E, Tang O, Patel S, et al.Ethnic differences and comorbidities of 909 prurigo nodularis patients.J Am Acad Dermatol. 2018;79(4):714-719.e3. doi:10.1016/j.jaad.2018.04.047National Organization for Rare Disorders.Prurigo nodularis.Hughes JM, Woo TE, Belzberg M, et al.Association between prurigo nodularis and etiologies of peripheral neuropathy: suggesting a role for neural dysregulation in pathogenesis.Medicines (Basel). 2020;7(1):4. doi:10.3390/medicines7010004
American Academy of Dermatology Association.Prurigo nodularis: causes.
Kwon CD, Khanna R, Williams KA, Kwatra MM, Kwatra SG.Diagnostic workup and evaluation of patients with prurigo nodularis.Medicines (Basel). 2019;6(4):97. doi:10.3390/medicines6040097
Larson VA, Tang O, Stander S, Miller LS, Kang S, Kwatra SG.Association between prurigo nodularis and malignancy in middle-aged adults.J Am Acad Dermatol. 2019;81(5):1198-1201. doi:10.1016/j.jaad.2019.03.083
Huang AH, Canner JK, Khanna R, Kang S, Kwatra SG.Real-world prevalence of prurigo nodularis and burden of associated diseases.J Invest Dermatol. 2020;140(2):480-483.e4. doi:10.1016/j.jid.2019.07.697
Boozalis E, Tang O, Patel S, et al.Ethnic differences and comorbidities of 909 prurigo nodularis patients.J Am Acad Dermatol. 2018;79(4):714-719.e3. doi:10.1016/j.jaad.2018.04.047
National Organization for Rare Disorders.Prurigo nodularis.
Hughes JM, Woo TE, Belzberg M, et al.Association between prurigo nodularis and etiologies of peripheral neuropathy: suggesting a role for neural dysregulation in pathogenesis.Medicines (Basel). 2020;7(1):4. doi:10.3390/medicines7010004
National Organization for Rare Disorders (2021).Prurigo Nodularis - NORD (National Organization for Rare Disorders)
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