Symptoms and signs of prurigo nodularis
Find out what prurigo nodularis (PN) is, the signs and symptoms of PN, and how it can impact your life.
Signs and symptoms
There are multiple signs and symptoms associated with PN, but you may experience them differently to others living with the condition.11 Below, we’ll look at what they are and how they can present.
Itch
People with PN may experience the most severe type of itch compared to other skin conditions with chronic itch.12 Although the itch tends to be more concentrated in the nodules, areas without nodules can be severely affected too.11 It may also be accompanied by burning or pricking sensations, pain and bleeding.7,11 You can learn more about the itch and why you may find it difficult to stop scratching.
Bumps, nodules and other raised lesions
PN is characterised by bumps on the skin, which are identified as dome-shaped nodules, papules, or plaques.1,5,11 These can vary in size, from just a few millimetres to up to 2 centimetres.1,3 Bumps can appear anywhere on your body, but you’re most likely to find them on your torso or back and often symmetrically distributed on your legs and arms.11,13 They may first show as small, intensely itchy rashes which are concentrated to certain areas of the skin.13 But for some people, when scratched continuously over time, they may become larger and more dome shaped.13
Bumps can be the same colour as your skin, or they may differ.2,4
The colour of your nodules depends on your skin tone. If you have White or lighter skin, they could appear pink, red or maroon.2–4,13 However, if you have Black or darker skin, they may be brown, black, purple or grey.2,4,13 Nodules can also leave dark spots (hyperpigmentation) on the skin when healing, which can take longer to fade on darker skin tones.13
Who is affected by prurigo nodularis?
PN can affect anyone of any age, but it’s more common in women and adults over the age of 50.1,4,9 People with certain health conditions may be more likely to develop PN, but it can develop on its own too.1,3,6,10 Speak to your doctor or dermatologist to learn more about how your PN may be linked to other conditions.
There are around 10.000 people living with PN in Belgium
Although PN is considered a rare disease, people all over the world live with it – so you’re definitely not alone.9
The impact of PN goes beyond the skin2,10,14
Lifestyle impact
Many people living with PN find that their signs and symptoms can affect their quality of life.2,10,14 The intense itch and often highly visible marks can make it difficult to engage in social activities, and it may also impact your performance at school or work.2,7
Sleep
PN can make getting to sleep tough, as the itch tends to feel more intense at night.14 In fact, over 60% of people living with PN reported that their sleep is significantly worsened by their itch.14
The lack of sleep can then negatively impact your energy levels,15 which is why you might find that you can’t concentrate during the day.
Living with PN
Some people may feel ashamed, or embarrassed by how their skin looks, or find that their PN is affecting their mood or emotions.5,10
PN is also associated with mental health conditions, such as anxiety and depression.5,7,10 You can read more about how PN can affect your mental wellbeing, and where to find help and support.
Our knowledge of PN is changing
We still don’t know everything about PN. But ongoing research means we now have an improved understanding of the condition.16,17
It’s best to talk to your doctor or dermatologist about the different ways you could manage your PN. They may be able to help find an approach that works for you.
Commonly asked questions
We don’t know for certain what causes PN. But thanks to ongoing research, it’s now believed that the immune system, nervous system and skin are all likely to
play a role.1
No. PN is not contagious, so you can’t catch it from or pass it on to anyone else through physical contact.4
No, PN is not passed on through genetics.4 However, some of the conditions associated with PN are hereditary and run in families, such as atopic dermatitis.1,4,18
PN is not considered an autoimmune disease, but people who live with certain autoimmune conditions are more likely to have it.1 The immune system may play a role in causing PN through inflammation.1,8
There is no ‘cure’ for PN yet. But, with the right management approach, the signs and symptoms of your PN may improve over time.11,17–19
Living with PN Guide
Want to keep this information at hand? Our guide has everything
we’ve covered on this page – and a bit more.
Living with PN Guide
Causes of PN
Although PN affects the skin, its causes could run deeper.
See what underlying factors may be at play.
Managing and treating PN
Working together with a doctor or dermatologist, you
could find a way to manage your PN that works best for
you.
Living with PN
If PN is affecting your mental health, we can show you
where to find more help and support.
- National Organization for Rare Diseases. Prurigo Nodularis. Available at: https://rarediseases.org/rare-diseases/prurigo-nodularis/. Accessed March 2023.
- American Academy of Dermatology Association. Prurigo nodularis: Signs and symptoms. Available at: https://www.aad.org/public/diseases/a-z/prurigo-nodularis-symptoms. Accessed March 2023.
- Ryan S. Dermatol Nurs 2017; 16(4): 18–21.
- Yale Medicine. Prurigo Nodularis Overview. Available at: https://www.yalemedicine.org/conditions/prurigo-nodularis-overview. Accessed March 2023.
- Pereira M et al. J Eur Acad Dermatol Venereol 2018; 32(7): 1059–1065.
- Ständer H et al. J Am Acad Dermatol 2020; 82(2): 460–468.
- Pereira M et al. J Eur Acad Dermatol Venereol 2020; 34: 2373–2383.
- Williams KA et al. J Am Acad Dermatol 2020; 83(6): 1567–1575.
- Wikstrom K et al. Acta Derm Venereol 2021; 101: adv0050.
- Huang AH et al. J Invest Dermatol 2020; 140(2): 480–483.e4.
- Aggarwal P et al. Clin Exp Dermatol 2021; 46(7): 1277–1284.
- Mollanazar N et al. J Am Acad Dermatol 2016; 75(4): 842–844.
- DermNet NZ. Nodular Prurigo. Available at: https://dermnetnz.org/topics/nodular-prurigo. Accessed March 2023.
- Gwillim E et al. Acta Derm Venereol 2021; 101(3): adv00424.
- Podder I et al. Int J Womens Dermatol 2021; 7(4): 403–410.
- Mack M and Kim B. Trends Immunol 2018; 39(12): 980–991.
- Zeidler C et al. Dermatol Clin 2018; 36(3): 189–197.
- British Association of Dermatologists. Nodular Prurigo Patient Information Leaflet. Available at: https://www.bad.org.uk/pils/nodular-prurigo/. Accessed March 2023.
- American Academy of Dermatology Association. Prurigo nodularis: Diagnosis and treatment. Available at: https://www.aad.org/public/diseases/a-z/prurigo-nodularistreatment. Accessed March 2023.
Sanofi Belgium, MAT-BE-2400922. V.1. 11/2024