Prurigo Nodularis In a Patient
I wanted to share a post today from a former patient who came to me with PN (Prurigo Nodularis). PN is an agitating condition causing patients severe itching and intense mental stress.
PN is intense skin flare-ups where a small mass of skin creates a hard bump of flakey skin creating an extremely intense itching sensation. The itching sensation is taxing on the patient and a vicious cycle. The more you itch the greater the sensation. Many dermatologists treat PN so you may ask why did she come to me, an infectious disease doctor?
I have discussed in my blogs the importance of immunoglobulin workups. In many of my practice cases, patients experiencing illnesses or conditions like PN could be experiencing these because of an immunoglobulin (IgG) deficiency. Immunoglobulin (IgG) deficiency, which severely lowers the immune system, can explain chronic infections and conditions. This is why I so strongly urge patients and doctors to have proper testing and workups performed to identify the underlying issues and stop reoccurrence. In this particular case, this patient came to me for her PN here is her story…
“I was ‘cured’ for three years after having intravenous antibiotic therapy in 2005. Then in 2008, I started having a relapse. My infectious disease doctor did more tests and found that I have immunoglobulin (IgG) deficiency which severely lowers my immune system. Any disease that affects the immune system (lupus, thyroid issues etc) can cause PN. So I’m convinced that PN is a symptom, not a disease.
After two years of trying to boost my immune system but watching the PN relapse progress, my doctor and I decided to go for the I.V. antibiotic therapy again. I’m now on a new med called Televancin which targets the skin. It’s been 2.5 weeks in and the PN is about 40% healed. I’ll probably be on the med for 6-8 weeks. After the lesions clear up, I’m going to work harder to boost my immune system. This may include monthly IgG infusions.
Dermatologists do not look at the underlying causes of PN, they just treat the symptoms. My doctor has treated about a dozen people with PN and other skin infections, with 90% cure rate. He is willing to fight the insurance companies to get us on the heavy-duty I.V. stuff.
There are others out there who were cured of PN. Some were cured with thalidomide, some with alternative therapies, some with antibiotics. But I think if the immune system gets really low there is a good chance for a relapse. Sometimes I wish I could live in a little stress-free bubble….”
(User name TJUNE 5/1/14 http://prurigonodularissupport.yuku.com/topic/978/Newly-Diagnosed-with-PN)
Please see user TJUNE story and join her support forum for those diagnosed with PN.