A case of recalcitrant prurigo nodularis accompanied by megaloblastic anemia = A case of recalcitrant prurigo nodularis accompanied by megaloblastic anemia

다국어 초록 (Multilingual Abstract)

Prurigo nodularis is a chronic condition induced by scratching, most commonly due to itching. Various systemic conditions are known to be associated, such as atopic dermatitis, renal insufficiency and liver diseases. Out of these conditions, anemia may also be as a cause to induce pruritus. A 46-year-old male presented with a3-year history of generalized pruritic hyperpigmented pea-sized hyperkeratotic nodules on whole body. He had no medical history and was referred to us from anotherclinic under the impression of prurigo nodularis, when no improvements were observed with various treatments. Biopsy was done, and the diagnosis was consistent with prurigo nodularis. Numerous treatments were tried, including narrow-band UVB, as well as systemic cyclosporine, which were all ineffective. Laboratory examinations revealed a hemoglobin level of 11.3g/dl, and a hematologist was consulted after persistence of anemia. The patient was diagnosed with megaloblastic anemia due to vitamin B12 deficiency, and was started with injections to replace cobalamin. The anemia was not easily corrected,and the patient’s symptoms persisted nonetheless. Prurigo nodularis is a chronic condition with severe pruritic skin lesions. The causes that initially induced the pruritus are diverse, and may be unidentified. Anemia is known to cause pruritus, and in this case, anemia may be the initial trigger that eventually led to prurigo nodularis.