Many people have NOT heard about prurigo nodularis, but I feel like we will hear about it more and more in the coming years. It's incredibly ITCHY, and so many people have suffered from it because it's so relatively new in regards to being diagnosed. Prurigo nodularis nodules tends to be in middle-aged people, and it occurs in people who have not had skin issues their whole life! That's why I brought on the Super Man of "itch", and he does a deep dive in prurigo nodularis and how you can treat it. My guest today is Shawn Kwatra, MD is a Director of the Johns Hopkins Itch Center and an Associate Professor of Dermatology at the Johns Hopkins University School of Medicine in Baltimore, MD, USA. He specializes in medical dermatology areas of clinical expertise include atopic dermatitis, psoriasis, chronic itch of unknown origin and dermatology for ethnic skin. Dr. Kwatra also runs a basic science laboratory and clinical trials unit and is funded by the National Institutes of Health and multiple foundations. Dr. Kwatra has been an author or co-author on over 200 publications and author of the book Living with Itch. If you've dealt with prurigo nodularis, what helped quell the extreme itch? I'd love to hear your tips and tricks in the comments! In this episode: What is prurigo nodularis + what are the telltale symptoms? Some possible immune system triggers to watch out for Thoughts on current treatment options (+ what's coming down the pipeline) Cormorbitidities strongly associated with prurigo nodularis (watch out for these!) Is prurigo nodularis itch histamine-driven? (issues with using antihistamines) How prurigo nodularis impacts mental health (WOW) Quotes "Prurigo nodularis is arguably the itchiest of itch disorders. And so that leads to this impaired sleep. Then that can just wreck your whole life." [14:00] "In prurigo nodularis, you don't necessarily have that impaired barrier, but you have this stimulus of intense itch and skin thickening that then leads to secondary colonization (of bacterial infections)." [7:39] Links Find Dr. Shawn Kwatra online here and here Follow Dr. Kwatra on Twitter Get Dr. Kwatra's book Living with Itch: A Patient's Guide Healthy Skin Show ep. 275: Why You're So Itchy (HINT: It's Probably Not Histamine) w/ Dr. Shawn Kwatra Healthy Skin Show ep. 257: Itchiness + Histamine Intolerance – Why Am I Itchy? Healthy Skin Show ep. 070: Stopping The Itch In Children & Babies w/ Dr. Elisa Song