Redrawing the Map in Prurigo Nodularis: From Conventional Approaches to Targeted Biologics
Year: 2026
Type: article
Abstract: Background Prurigo nodularis (PN) is a chronic, neuroimmune‐mediated dermatosis characterized by intense pruritus and nodular lesions that severely impair patient quality of life. The limitations of conventional therapies in providing more than symptomatic relief have necessitated novel approaches targeting the disease’s heterogeneous pathogenesis. Objective This review evaluates current treatment algorithms and the potential future clinical frameworks tailored to the immunological and neuropathic endotypes of PN. Methods A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, and Google Scholar databases for English‐language peer‐reviewed articles, clinical trials, and guidelines published up to December 2025, focusing on targeted and conventional therapies for prurigo nodularis. Results In addition to approved biologics such as the IL‐4/IL‐13 pathway inhibitor dupilumab and the IL‐31 receptor antagonist nemolizumab, this review discusses emerging options, including JAK inhibitors, mast cell–targeted therapies, and opioid modulators. Current evidence suggests that these targeted agents offer significant improvements in both pruritus and lesion resolution by addressing specific molecular drivers. Conclusion The management of PN is entering a transitional phase, with an emerging goal to evolve from uniform approaches toward future biomarker‐ and phenotype‐based, disease‐modifying, and personalized strategies. Defining these endotypes more precisely will be essential for optimizing potential therapeutic individualization and long‐term clinical success.
Source: Dermatologic Therapy
DOI: 10.1155/dth/1342428
Author: Göknur Kalkan
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,700
OpenAlex ID: W7202378071