A 54 year-old man had developed several scattered, itchy, excoriated erythematous papules on both the arms and back (5 years previously). He had no underlying disease. The clinical diagnosis was prurigo nodularis and treatment was started. Oral cyclosporine (200 mg/day) was taken for 1 year, but his symptoms waxed and waned. Treatment was changed to oral alitretinoin (30 mg/day). Within 16 weeks of treatment, the symptoms and skin lesions had improved more than with previous treatment. His treatment with oral alitretinoin continued for 3 years without progression or any side effects.
A 54 year-old man presented with multiple, 1 month-old, itchy erythematous maculopapular patches on both legs, both arms, and back, which were diagnosed as prurigo nodularis. He had no underlying disease. Treatment with oral cyclosporine (50 mg/day) was started. However, his blood pressure exceeded the hypertension borderline after 8 weeks of treatment even though he had no underlying hypertension. Therefore, the treatment was changed to oral alitretinoin (30 mg/day) for 2 weeks. His itching sensation was reduced after the treatment without recurrence.