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 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.