Taiwanese Dermatological Association consensus for the diagnosis and management of prurigo nodularis

Prurigo nodularis (PN) is a chronic neuroinflammatory skin disease that, while considered rare, is likely underestimated. Due to its complex presentation, misdiagnosis is not uncommon, highlighting the need for greater awareness among healthcare professionals to ensure the accurate diagnosis and appropriate management. To address this need, the Taiwanese Dermatological Association (TDA) established an expert panel to develop a consensus on the management of PN in Taiwan, aiming to enhance the clinicians’ understanding and guide their therapeutic approaches to improve the clinical outcomes for PN patients. A panel of eight core members was convened to review and discuss the aspects of PN management, drafting a consensus during the meetings. The 2020 Germany Diagnostic and Treatment Algorithm and the 2021 United States Expert Panel Consensus for chronic PN, along with recent literature and local practices, served as the foundation for this consensus. The information was agreed upon by the expert panel during TDA PN consensus core meetings held on January 25, June 1, and August 1, 2024. This consensus provides a comprehensive overview of the diagnosis and treatment of PN, with considerations specific to practitioners in Taiwan. Topical and systemic treatments, as well as phototherapy are utilized to manage the disease. The recent approval of dupilumab and the emerging targeted therapies are expected to significantly benefit patients who are inadequately managed by existing options.