A 41 year-old woman presented with localized brownish papules and patches with crust and a scaly skin lesion. She had chronic kidney disease. Her skin lesion was diagnosed as prurigo nodularis. Because of her impaired kidney function, medication that might impair renal function was limited. Treatment with oral alitretinoin was selected in a dose of 30 mg/day. Within 4 weeks of treatment, the symptoms had improved compared to conventional treatment. She continued treatment with oral alitretinoin during which the symptoms waxed and waned.
A 75 year-old man presented with multiple scattered nodules and excoriated patches with crusts on the trunk, both arms, and both legs that were two weeks old. He had no underlying disease. The initial clinical diagnosis was prurigo nodularis and treatment was started. Despite treatment with oral cyclosporine (100 mg/day) for 3 years, his symptoms and skin lesions waxed and waned. After that, the treatment was changed to oral alitretinoin in a dose of 30 mg/day. Within 12 weeks of treatment, pruritus had improved and treatment with oral alitretinoin was stopped with partial remission.