Treatment was begun with herbal medicine Derma-zema herbal compound formulation administered in the standard dosing regimen. As patient located overeases, he reported numeric rating scale itch intensity (NRSi), measured on a scale of 0 to 10 (10 representing the worst possible itch) over the tele-communicaiton, the photos self-taken were recorded before and after treatment. He reported an NRSi of 9 of 10 before initiating treatment with our herbal medicine. After 1 month of treatment, the patient’s reported NRSi was between 7 and 8, NRSi of 4 at month 9, at 15-month follow-up, the patient reported an NRSi of 0 (Fig.1I and Fig.2 C). The overall size and number of prurigo lesions decreased significantly (Fig.1I and Fig.2 C). No adverse events were reported during the 15 months follow-up.
No therapies have been approved by the Food and Drug Administration for prurigo nodularis, and treatment is challenging. Nearly all patients failed to respond to topical glucocorticoids and antihistamines. Many patients also do not have a response to off-label use of systemic therapies such as methotrexate, cyclosporine and thalidomide which have undesirable side effects . While the present case report is limited, the response following herbal treatment in this patient is encouraging. Our findings raise the prospect of a nonharmful botanical therapy for the treatment of PN, which deserves additional study.