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.
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.