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 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.