Prurigo simplex is symmetrically distributed with small intensely itchy papules, which is in dome-shaped and topped with a small vesicle. The vesicle is usually present only transiently because of its immediate removal by scratching, so that a crusted papule is more frequently seen. Prurigo papules are present in various stages of development and are seen mostly in middle-age or elderly persons of both genders. The trunk and extensor surfaces of the extremities are common sites. Other areas include the face, neck, lower trunk, and buttocks. The lesions usually appear in crops, so that papulovesicles and the late stages of scarring may be seen at the same time .
The histopathology of prurigo simplex is nonspecific but often suggests an arthropod reaction. Spongiosis accompanied by a perivascular mononuclear infiltrate with some eosinophils is often found [2-4].
Many conditions may cause pruritic erythematous papules. Scabies, atopic dermatitis (eczema), insect bite reactions, papular urticaria, dermatitis herpetiformis, contact dermatitis, pityriasis lichenoides et varioliformis acuta (PLEVA), transient acantholytic dermatosis (TAD), papuloerythroderma of Ofuji, dermatographism, and physical urticarias should be considered. Biopsy may be helpful in differentiating dermatitis herpetiformis, PLEVA, TAD, and on occasions, unsuspected scabies [1,2,4].
Prurigo Simplex also called papular dermatitis, subacute prurigo, “itchy red bump” disease. We herewith present a 50- year-old female with prurigo simplex triggered by hair dyes. Some small dome-shaped nodules resembling insect bites developed on her neck and forehead area, then the bumps spread over her lower trunk, arms, legs and buttocks. She was given topical steroids and antihistamine which avail little. Itching became severe and habitual, her condition was worsening. We administer TCM herbal medication, prurigo simplex nodules respond every well and reach full clearance after 7 months of treatment.
- James, William; Berger, Timothy; Elston, Dirk (2011). Andrews’ Diseases of the Skin: Clinical Dermatology. (11th ed.). Elsevier
- Bakker CV, et al: Bullous pemphigoid as pruritus in the elderly. JAMA Dermatol 2013; 149:750–753.
- Clark AR, et al: Papular dermatitis (subacute prurigo, “itchy red bump” disease). J Am Acad Dermatol 1998; 38:929.
- Gambichler T, et al: Immunophenotyping of inflammatory cells in subacute prurigo. J Eur Acad Dermatol Venereol 2011; 25:1221–1226.