DEAR DR. ROACH: I found your column about granuloma annulare very interesting. I understand the writer’s frustration at not finding a cure for the problem.
Could you write about another skin condition that is also very resistant to treatment, prurigo nodularis? My husband has had it for several years, and it does not seem to respond to any treatment. — I.F.
ANSWER: Prurigo nodularis is an itchy skin condition of unknown cause. The disease is characterized by firm, dome-shaped, itchy nodules, most commonly on the backs of the arms and fronts of the legs, and sometimes on the body. They can be skin-colored, reddish or dark brown. Some people have only a few; others have hundreds. The itching is severe and is made worse by warm weather, sweating and irritation from clothing.
Dermatologists are the experts in treating this condition. Sometimes a biopsy is necessary to confirm the diagnosis. It usually is treated with powerful prescription-strength steroids, usually creams or ointments, but occasionally by injection. Capsaicin cream also has been helpful. Very severe cases may need medication, such as thalidomide by mouth, but only an expert should be prescribing that.
READERS: The booklet on herpes and genital warts explains these two common infections in detail. Readers can obtain a copy by writing: Dr. Roach — No. 1202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow 4-6 weeks for delivery.