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 41 year-old woman presented with localized brownish papules and patches with crust and a scaly skin lesion. She had chronic kidney disease. Her skin lesion was diagnosed as prurigo nodularis. Because of her impaired kidney function, medication that might impair renal function was limited. Treatment with oral alitretinoin was selected in a dose of 30 mg/day. Within 4 weeks of treatment, the symptoms had improved compared to conventional treatment. She continued treatment with oral alitretinoin during which the symptoms waxed and waned.