Prurigo nodularis: Signs and symptoms
Where does prurigo nodularis develop on the body?
Prurigo nodularis causes itchy bumps on the skin, which appear when someone repeatedly scratches, picks at, or rubs their skin. These itchy bumps, which dermatologists call "nodules," can develop anywhere on skin that you can scratch, pick, or rub.
While the itchy bumps can develop anywhere, most appear on one or more of these areas:
What are the signs and symptoms of prurigo nodularis?
The following describes what you may experience if you have prurigo nodularis.
Before the itchy bumps of prurigo nodularis appear, the skin often itches. This itch can be long-lasting or come in short bursts. Either way, it's often intense. Some people have a few itchy areas. For others, the itch covers much of their skin.
Skin may burn or sting
Instead of feeling itchy, some people say that their skin burns or stings. While rare, patients have said they experience other sensations, like the feeling that bugs are crawling on their skin.
Itchy bumps (nodules) develop
The repeated scratching, picking, or rubbing leads to itchy bumps. The itchy bumps usually appear about six weeks after your skin starts to itch, burn, or sting. Often, the bumps develop evenly on both sides of the body.
Itchy bumps vary in color, size, and number
The bumps can be the color of your skin, pink, red, or brownish black. The size may vary from that of a pinhead to larger than a U.S. quarter. It’s possible to have a few bumps or more than 100 on your skin. For most people, this number falls somewhere in between.
Raised, itchy patches can also develop on the skin.
Scratching can change the skin
Frequently scratching can cause more bumps and raised patches of itchy skin. The more you scratch, the itchier your skin may feel. Some people scratch until the itchy bumps or patches break open and bleed or the skin feels too painful to touch. All this scratching can cause changes. Dark spots may appear. The skin can feel pebbly or hard and thick.
Dark spots, light spots, or scars can appear as the bumps clear
Without treatment, the itch and bumps can last for months or years (A). As the bumps clear, you may see flat dark spots (B), spots that are lighter than your natural skin color, or scars where the bumps once were.
Prurigo nodularis can affect a person’s quality of life
Living with severe and frequent itch can affect your quality of life. Patients have told their dermatologist that the itch causes them to:
Have trouble sleeping
Miss days from work (or school)
Feel sad, shameful, or helpless
Limit social activities
Some people have a greater risk of developing prurigo nodularis. Find out if you do, at: Prurigo nodularis: Causes.
Images 1-2: Getty Images
Images 3–6: Used with permission of the Journal of the American Academy of Dermatology and JAAD Case Reports:
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J Am Acad Dermatol; 2013;69:426-30.
J Am Acad Dermatol; 2020;83:1559-65.
JAAD Case Reports; 2019;5:471-3.
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Paula Ludmann, MS
Shari Lipner, MD, PhD, FAAD
Klint Peebles, MD, FAAD
Caroline Robinson, MD, FAAD
Last updated: 9/14/21