Prurigo Nodularis and Comorbidities

Raja Sivamani, MD, MS (00:07):

I am Raja Sivamani. I'm a board-certified dermatologist. I'm actually an integrative dermatologist because I have training in Ayurvedic medicine as well. I practice in Sacramento, California. We have a private practice there. We see a lot of Medi-Cal patients as well, so I really am interested in treating the underserved. And as such, I also do a lot of clinical research. So I get to play in both worlds of clinical care and clinical research.

(00:32):

One question that I get a lot is, how often do I see other systemic conditions that come along with prurigo nodularis? One of the really fun things about taking care of prurigo nodularis patients, because we see a lot of these patients with other medical conditions. Now, one of the things about PN is that it can be primary. It doesn't have to be secondary to something else, and that's a common misconception. However, you do want to look for other conditions too. If you have renal insufficiency, that can lead to significant amount of itching. If you have liver issues, maybe if you have an underlying cancer. So there are things that we have to screen for. So basic labs, making sure in their medical history they haven't had any sort of other conditions, and then new medications. Sometimes when people start a new medication, they get this tremendous amount of itch that can also result in PN.

(01:21):

But the bottom line is, you don't have to have another medical condition. You can actually just have PN because it's primary. That's something that can easily be forgotten, but we have to keep that at front of mind.