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 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.