Nodular Dermatitis

What You Need To Know About Nodular Dermatitis

Nodular dermatitis is a term pertaining to dermal infiltration in the form of clusters either solitary or multiple.

The disease is similar to another skin disease called Prurigo nodularis.

The condition is characterized by itchy nodules usually appearing on the arms or legs.

Some of the patients suffering from the disease exhibits multiple excoriated lesions caused by excessive scratching.

The effects of nodular dermatitis can be adverse mainly due to pruritus, which is the chronic urge or reflex to scratch.

There will be an evident destruction of the skin.

The causes of nodular dermatitis as well as PN are still unknown. However, there are pre-existing conditions, i.e. Becker's nevus, linear IgA disease, autoimmune condition, and T cells, which can induce nodular dermatitis. The disease can also be linked to internal malignancies, liver and renal failure.

Repetitive scratching of the affected area may result in lasting changes in the skin of patients suffering from nodular dermatitis. Other adverse effects of excessive scratching brought about by the disease include: lichenification, hyperkeratosis, increase in the pigmentation and thickening of the skin.

Those with excoriated lesions exhibit scaly or crusted skin accompanied by scabs. Patients suffering from the disease often seek treatment during middle-age. It is also possible to have a history of chronic severe pruritus and significant medical history of unrelated conditions.

Those who have a history of eczema, especially atopic dermatitis usually exhibit nodular dermatitis at any age. Patients suffering from HIV or AIDS are also vulnerable and may develop the affliction.

The nodules produced by nodular dermatitis are discrete, hyperpigmented, firm and mostly symmetrical.

Additionally, the nodules are greater than 0.5cm in both width and depth. The excoriated lesions are often flat and have crusts on top. During the onset of nodular dermatitis, the nodules may begin to appear in the hair follicles making the pattern of invasion follicular.

Common Diagnosis and Treatment for Nodular Dermatitis

Like prurigo nodularis, the nodular dermatitis can be diagnosed based on visual examination and presence of itching. The physician would also conduct a skin biopsy in order to exclude other diseases that the patient is suffering from.

To distinguish if the nodular dermatitis is secondary to atopic dermatitis, a culture of at least one lesion would be conducted. This will determine if there is an infection of staphylococcus.

The condition is very hard to treat. However, there are existing therapies available including the application of steroids and vitamins, cryosurgery and thalidomide.

Treatment through UVB light is also available. Antibiotics may be administered if there is an evidence of staphylococcal infection or other infections.

The physician may also administer a strong dose of prednisone that will immediately stop the itch and scratch cycle.