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Suggest Treatment For Prurigo Nodularis And Hypopiturism

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Posted on Wed, 30 Apr 2014
Question: I am looking for treatments of Prurigo Nodularis and hypopiturism
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Answered by Dr. Dr. Rahul Kumar (3 hours later)
Brief Answer: thalidomide and hormone replacement Detailed Answer: Hello Thanks for the query and reports. Prurigo nodularis is a non specific allergic condition of skin leading to development of highly itchy rash on body. Treatment is with anti histamines. I have seen very good response with capsule thalidomide. Hypopitutarism needs hormone replacement. Pitutary produces many hormones like growth hormone, thyroid stimulating hormone etc. Levels of each hormone need to be assessed and replacement done if required. Please meet an endocrinologist and discuss regarding this. Let me know if you have any other doubts. Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Rahul Kumar (27 minutes later)
one is a pic of my arm with nodule. my current meds are Prednisolone 7.5 mg crestor 10 mg synthroid 0.05 mcg metaformin 5oo mg /day . I can not tolerate testosteron in any form use Clobetasol ointment for my nodules THIS IS A VERY BASIC INFORMATION ABOUT DISEASE PROCESS. I TRIED THALIDOMIDE BUT JUST FOR 2 MONTHS AND I USE TO GET FAITING SPELLS AND IT MADE MY NODULES HUGE AND DEEP , MORE SCATTERED ON STOMACH AND ARMS.ON MY ARMS IT WASALMOST NEAR THE BONE AND STOMACH HAD 3-4 INCHES DEEP WOUNDS WITH DEEPER TUNNELS. A PATIENT WHO HAS SUFFERED THE DISEASE KNOWS THIS MUCH OR POSSIBLY MORE. I WAS HOPING TO HEAR ABOUT ANY PULSING OF TESTOSTERONE ETC, NOT SATISFIED WITH BASIC INFORMATION XXXX
doctor
Answered by Dr. Dr. Rahul Kumar (6 hours later)
Brief Answer: HCG injection, doxepin Detailed Answer: Hello Mr XXXXXXX Thalidomide is the best available treatment for prurigo nodularis hence I suggested that. However as you correctly mentioned it doesnt suit all. There are side effects like sedation and dizziness. I can see lot of ulceration in the picture attached by you. An antibacterial cream is must at this stage. Please apply ointment mupirocine twice daily for a week. This will take care of infection and also protect the nodules from getting infected. Also you can try capsule doxepin, It is less sedative when compared to thalodimide. You can discuss with your doctor regarding doxepin. Regarding hypopitutiarism, Thyroid and adrenal glands are already taken care by your doctors as you are on prednisolone and synthyroid. Testosterone pulsing is done by using either tablets or testosterone patches. As you have mentioned you cannot tolerate testosterone in any form, you can go for HCG injection. Let me know if you have any other doubts. Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rahul Kumar (2 hours later)
I am using mupirocin and fucidin plus clobetasol since many years . HCG option appears worth discussing with my Endo. Thanks very much. the Canadian healthcare system is terrible. I will continue to ask questions. my initial testo trial was so bad that I had to take 40 mg Prednisoloneand then taper it. I worked with a company that introduced Doxeoin m the TCA. I was pushed all kinds of neuroleptics and TCA's but never took any. I take loads of gabapantine / atarax / gravol for sleep. once again many thanks for giving me hopes. I need some more energy and hopefully HCG might help
doctor
Answered by Dr. Dr. Rahul Kumar (2 hours later)
Brief Answer: Welcome Detailed Answer: You are most welcome. I am glad I could help you. Hope this works for you. Thank you
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Rahul Kumar

Dermatologist

Practicing since :2010

Answered : 6635 Questions

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Suggest Treatment For Prurigo Nodularis And Hypopiturism

Brief Answer: thalidomide and hormone replacement Detailed Answer: Hello Thanks for the query and reports. Prurigo nodularis is a non specific allergic condition of skin leading to development of highly itchy rash on body. Treatment is with anti histamines. I have seen very good response with capsule thalidomide. Hypopitutarism needs hormone replacement. Pitutary produces many hormones like growth hormone, thyroid stimulating hormone etc. Levels of each hormone need to be assessed and replacement done if required. Please meet an endocrinologist and discuss regarding this. Let me know if you have any other doubts. Thank you