A 42 year-old man presented with multiple scaly erythematous itchy papules on the whole body that were 12 months old. He had hypertension and diabetes mellitus. The clinical diagnosis was prurigo nodularis and treatment was started. Despite taking oral antihistamine and cyclosporine (200 mg/day) for 4 weeks, the patient’s symptoms were not improved. Medication was changed to oral alitretinoin in a dose of 30 mg/day. Within 5 weeks of treatment, symptoms had improved. The treatment of oral alitretinoin was continued for 12 weeks until complete remission and was stopped afterward without recurrence.
A 65 year-old man had developed multiple, scattered, itchy excoriated erythematous papules on both arms starting 2 years prior. He had no underlying disease. The biopsied skin lesion showed hyperkeratotic epidermis with acanthosis. Elongated and irregular rete ridges were observed. The final diagnosis was prurigo. He was treated with oral cyclosporine (25 mg/day) and naltrexone (50 mg/day), and there was no improvement in the symptoms within 2 years. Therefore, the oral alitretinoin treatment (30 mg/day) was started. After 3 weeks of alitretinoin treatment, the patient achieved partial remission. The skin lesions and itching sensation were improved and the patient stopped medical treatment.