Observational studyThe Journal of dermatology2026
Characterization of Prurigo Nodules in Adults With Moderate-To-Severe Atopic Dermatitis in Japan: A 2-Year Observational Study.
Observational study in The Journal of dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Clinical phenotypes of atopic dermatitis (AD) can vary, with some individuals displaying difficult-to-treat prurigo nodularis-like lesions. We aimed to assess the real-world disease burden and treatment course of Japanese adults with AD-associated prurigo nodules (AD-Pn) receiving conventional AD treatments. Of the 300 participants with moderate-to-severe AD registered in the observational ADDRESS-J study between July 29, 2016 and July 4, 2017 (before the first biologic for AD was introduced), 285 had baseline and post-baseline prurigo assessments and were included in this exploratory analysis (108 with AD-Pn and 177 without Pn). Participants with AD-Pn versus those without Pn included more males (73.1% vs. 53.1%), and had more mean ± standard deviation (SD) visits for AD treatment in the previous year (11.5 ± 16.1 vs. 8.7 ± 6.6 visits), a higher proportion with an Investigator's Global Assessment (IGA) 4 score (39.9% vs. 18.6%), a higher mean ± SD Eczema Area and Severity Index (EASI) score (28.4 ± 15.1 vs. 23.5 ± 15.5), and a higher mean ± SD Patient-Oriented Eczema Measure (POEM) score (18.8 ± 6.2 vs. 15.6 ± 6.8). At baseline, 14.8% and 7.4% of participants with AD-Pn had been treated with oral immunosuppressants and oral corticosteroids, respectively, compared with 8.5% and 2.3%, respectively, of those without Pn. Individuals with AD-Pn previously received more intensive topical treatments. At 2 years, participants with AD-Pn had more severe AD than those without Pn, as assessed by IGA 4 scores (9.1% vs. 0.9%), and higher mean ± SD EASI total scores (12.5 ± 10.7 vs. 7.0 ± 8.1). In summary, individuals with AD-Pn were mostly males, whose AD was more severe and had improved less than those without Pn while receiving mostly conventional AD treatments over 2 years. AD-Pn might be an indicator for targeted treatment to improve long-term AD outcomes. Clinical Trial Registration: ADDRESS-J (UMIN Clinical Trial Registration: UMIN000022623).
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