CLINICAL PROFILE AND TREATMENT OUTCOMES OF CHRONIC PRURIGO IN PATIENTS ATTENDING A TERTIARY CARE DERMATOLOGY OUTPATIENT DEPARTMENT: A RETROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Chronic prurigo is a distinct, itch-driven skin disease marked by long-standing pruritus, a history of repeated scratching and firm pruriginous lesions, most often nodules. It is difficult to treat and weighs heavily on quality of life, yet real-world data on how these patients present and respond to treatment in Indian tertiary settings are limited.

Objectives: To describe the clinical profile of patients with chronic prurigo attending a dermatology outpatient department and to assess the outcomes of the treatments they received.

Methodology: This was a hospital-based, retrospective, observational study of 96 patients with chronic prurigo whose records were reviewed at the dermatology outpatient department of Geetanjali Medical College & Hospital, Udaipur, between December 2023 and May 2024. Demographic details, itch duration, lesion morphology, underlying causes, comorbidities and the treatments given were extracted from case files. Itch severity was recorded on a 0 to 10 numerical rating scale (NRS). Response at 12 to 16 weeks was graded as marked, partial or poor. Data were analysed with descriptive statistics and the paired t-test using Jamovi software.

Results: The mean age was 48.5 (SD 14.2) years, with a slight female majority (56.3%) and most patients from rural areas (60.4%). The nodular type predominated (70.8%), lesions favoured the extensor limbs, and baseline itch was severe in 68.8%. An underlying dermatological or systemic cause was identifiable in most patients, led by atopic diathesis (31.3%), psychiatric conditions (27.1%) and type 2 diabetes (22.9%); 20.8% had no identifiable cause. Nearly all patients received topical corticosteroids and antihistamines, with gabapentinoids, narrowband UVB, methotrexate and, in a few, dupilumab added in refractory cases. Among 88 patients with follow-up, a marked response was seen in 45.5%, partial in 38.6% and poor in 15.9%. Mean itch NRS fell from 7.8 to 3.9 (p < 0.001). Response rates were highest with dupilumab and narrowband UVB.

Conclusion: Chronic prurigo in this population affected middle-aged adults, was frequently linked to an identifiable systemic or psychiatric condition, and improved in most patients with a stepwise, individualised regimen. Screening for underlying causes and early escalation in refractory disease are worth building into routine care.