A 78 year-old man diagnosed with prurigo nodularis had itchy multiple erythematous to brownish papules on both flanks, chest, and back that were 6 months old. He had no underlying disease. Oral cyclosporine (50 mg/day) was taken for 1 year. His symptoms waxed and waned. In our study, oral alitretinoin (30 mg/day) was started. Within 2 weeks of treatment, the skin lesions and pruritus had improved. The patient was treated with oral alitretinoin for 14 weeks until complete remission and then the treatment was stopped without recurrence.
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.