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Prurigo Nodularis. Presented by Dr. Max Popper.
A 38-year-old white man has skin lesions which consist of hyperkeratotic nodules which are situated on the extensor surfaces of the arms and legs. The intervening skin seems to be normal. There are a few scattered lesions on the face and on the back. A single lesion consists of a hyperkeratotic nodule which is sharply confined and firm. All these nodules show excoriations on the summit. This condition is highly pruritic, especially in the evening. The patient has had this condition for 12 years.
Histological findings reveal all layers of the epidermis to be increased in size. There is a basket-like hyperkeratosis containing only occasional cells (parakeratosis). The granular layer is markedly increased in size. Acanthosis is present. The rete pegs are broad and elongated. Intra- and extracellular edema is not conspicuous. There is a round-cell infiltrate around the
Price H, Murphy EL, Underwood LJ. METROPOLITAN DERMATOLOGICAL SOCIETY OF LOS ANGELES. AMA Arch Derm. 1957;75(5):764–767. doi:10.1001/archderm.1957.01550170132029
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