Med Bull Sisli Etfal Hosp. Accepted Articles: SETB-46144 | DOI: 10.14744/SEMB.2024.46144

The Significant Role of Atopic Skin Diathesis in Prurigo Nodularis

Yasemin Erdem, Ozgke Impram Ntousounous, Esen Ozkaya
Department of Dermatology and Venereology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Türkiye

Objective: Atopic skin plays a significant etiological role in the development of prurigo nodularis (PN). In addition to atopic dermatitis (AD), atopic skin diathesis without eczema can also contribute to the development of PN due to its association with itching. This study aims to evaluate with PN in terms of AD/atopic skin diathesis, associated comorbidities, and clinical findings.
Methods: Patients diagnosed with PN based on clinical and histopathological findings between 2014 and 2024 were included in the study. Associated diseases that could contribute to the etiology of pruritus were recorded as comorbidities. The diagnosis of AD was evaluated using the Hanifin-Rajka’s diagnostic criteria and atopic skin diathesis using the Erlangen Atopy Score. Patients were classified as atopic and non-atopic groups, and these groups were compared in terms of demographic and clinical findings.
Results: The study included a total of 47 patients, of whom 15 (31.9%) were male and 32 (68.1%) were female. At least one comorbidity was identified in 89.4% (n=42) of the patients, and multiple comorbidities were found in 34% (n=16). Atopic dermatitis and/or atopic skin diathesis was present in 55.3% (n=26) of the patients. Among these, 53.8% (n=14) were diagnosed with AD, while 46.2% (n=12) had only an atopic skin diathesis. Compared to the non-atopic group, the atopic group had a lower median age (p=0.001) and higher serum total IgE levels (p=0.031).
Conclusion: In addition to AD, atopic skin diathesis without eczema also appears to play an important role in the etiology of PN. The lower age and higher IgE levels in patients are factors associated with atopic predisposition.

Keywords: Atopic dermatitis, atopic skin, prurigo nodularis, pruritus, systemic disease, xerosis

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Prurigo Nodulariste Atopik Deri Yapýsýnýn Rolü

Yasemin Erdem, Ozgke Impram Ntousounous, Esen Ozkaya
Ýstanbul Üniversitesi Ýstanbul Týp Fakültesi, Dermatoloji ve Venereoloji Anabilim Dalý, Ýstanbul

Amaç: Atopik deri prurigo nodülaris (PN) etiyolojisinde önemli bir rol oynamaktadýr. Atopik dermatit (AD) tanýsý alan hastalarýn yaný sýra, atopik deri yapýsý da kaþýntý ile iliþkili olarak PN etiyolojisinde rol alabilir. Bu çalýþmada amacýmýz PN tanýlý hastalarý, AD/atopik deri yapýsý, eþlik eden hastalýklar ve klinik özellikler açýsýndan deðerlendirmektir.
Gereç ve Yöntem: Çalýþmaya 2014-2024 yýllarý arasýnda klinik ve histopatolojik bulgular ile PN tanýsý konulan hastalar dahil edildi. Pruritus etiyolojisinde yer alabilecek hastalýklar komorbidite olarak kayýt edildi. Atopik dermatit tanýsý Hanifin-Rajka taný kriterleri ile, atopik deri yapýsý ise Erlangen atopi skoru ile deðerlendirildi. AD ve/veya atopik deri yapýsýna sahip olanlar atopik, bunlarýn dýþýndakiler non-atopik olmak üzere hastalar iki gruba ayrýldý. Bu gruplar demografik ve klinik bulgular açýsýndan karþýlaþtýrýldý.
Bulgular: Çalýþmaya 15 (%31.9)’i erkek, 32 (%68.1)’si kadýn toplam 47 hasta dahil edildi. Hastalarýn %89,4 (n=42)’ünde en az bir, %34 (n=16)’ünde birden fazla komorbidite tespit edildi. Hastalarýn %55,3 (n=26)’ünde AD (n=14) ve/veya atopik deri yapýsý (n=12) mevcuttu. Atopik grubun yaþ ortalamasý düþük (p=0,001), serum total IgE düzeyi yüksek (p=0,031) bulundu.
Sonuç: AD’nin yaný sýra izole atopik deri yapýsýnýn da PN etiyolojisinde önemli bir faktör olduðu görülmüþtür. Düþük yaþ ortalamasý ve yüksek IgE düzeyi atopik yatkýnlýk ile iliþkili bulunmuþtur. (SETB-2024-08-132)

Anahtar Kelimeler: Atopik dermatit, atopik deri, prurigo nodularis, kaþýntý, sistemik hastalýk, kseroz

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