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Introduction <p>Chronic nodular prurigo (CNPG), also known as prurigo nodularis, is an inflammatory neuroimmune skin disorder characterized by intense pruritus and nodular lesions resulting from scratching. CNPG affects patients’ health-related quality of life (HRQoL); however, the magnitude of burden and clinical implications remain underrecognized in dermatologic practice.</p> Methods <p>This systematic review was conducted in accordance with PRISMA 2020 guidelines. Searches of PubMed and the Cochrane Library (April 2025) identified observational studies reporting HRQoL, symptom burden, or unmet needs in adults with CNPG. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the STROBE checklist.</p> Results <p>Of 464 records identified, 23 studies met the inclusion criteria. CNPG was consistently associated with substantial impairment in HRQoL, primarily driven by uncontrolled pruritus. Mean Dermatology Life Quality Index scores ranged from 7 to 22, EQ-5D scores from 57.4 to 65.3, and Health Utilities Index Mark&#xa0;III scores were approximately 0.52, significantly lower than in control population (<i>p</i> &lt; 0.001). Pruritus emerged as the dominant symptom and central determinant of HRQoL impairment, reflected by elevated Itchy Quality of Life, 5-D Itch, and 5-D Pruritus Life Quality scores. Sleep disturbances were reported by up to 100% of patients, while anxiety and depressive symptoms affected 26–46% and 16–57% of patients, respectively. CNPG was associated with impairment in daily activities (up to 100%), occupational functioning (up to 83%), and social or sexual relationships (27–95%). Treatment satisfaction was low (mean 57.4%), and higher pruritus intensity was associated with worse HRQoL and lower satisfaction. However, no mediation analyses were performed, and causal relationships between pruritus severity and HRQoL impairment cannot be established.</p> Conclusions <p>CNPG is associated with a substantial and multidimensional disease burden extending beyond cutaneous manifestations. Pruritus may emerge as the central driver of this burden, underscoring the importance of systematic assessment of HRQoL and itch severity.</p>

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Impact of Chronic Nodular Prurigo on Quality of Life: A Systematic Review of the Literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月17日

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  • Pedro Herranz Pinto,
  • Bibiana Pérez García,
  • Victoria Bonne Moreno,
  • Beky Norela Ortiz,
  • Héctor David De Paz Fernández,
  • Luis Lizán

摘要

Introduction

Chronic nodular prurigo (CNPG), also known as prurigo nodularis, is an inflammatory neuroimmune skin disorder characterized by intense pruritus and nodular lesions resulting from scratching. CNPG affects patients’ health-related quality of life (HRQoL); however, the magnitude of burden and clinical implications remain underrecognized in dermatologic practice.

Methods

This systematic review was conducted in accordance with PRISMA 2020 guidelines. Searches of PubMed and the Cochrane Library (April 2025) identified observational studies reporting HRQoL, symptom burden, or unmet needs in adults with CNPG. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the STROBE checklist.

Results

Of 464 records identified, 23 studies met the inclusion criteria. CNPG was consistently associated with substantial impairment in HRQoL, primarily driven by uncontrolled pruritus. Mean Dermatology Life Quality Index scores ranged from 7 to 22, EQ-5D scores from 57.4 to 65.3, and Health Utilities Index Mark III scores were approximately 0.52, significantly lower than in control population (p < 0.001). Pruritus emerged as the dominant symptom and central determinant of HRQoL impairment, reflected by elevated Itchy Quality of Life, 5-D Itch, and 5-D Pruritus Life Quality scores. Sleep disturbances were reported by up to 100% of patients, while anxiety and depressive symptoms affected 26–46% and 16–57% of patients, respectively. CNPG was associated with impairment in daily activities (up to 100%), occupational functioning (up to 83%), and social or sexual relationships (27–95%). Treatment satisfaction was low (mean 57.4%), and higher pruritus intensity was associated with worse HRQoL and lower satisfaction. However, no mediation analyses were performed, and causal relationships between pruritus severity and HRQoL impairment cannot be established.

Conclusions

CNPG is associated with a substantial and multidimensional disease burden extending beyond cutaneous manifestations. Pruritus may emerge as the central driver of this burden, underscoring the importance of systematic assessment of HRQoL and itch severity.