856 Peripheral neuropathic changes in prurigo nodularis

Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by intensely pruritic and hyperkeratotic nodules of unknown etiology. PN strongly associated with peripheral neuropathies, suggesting role for neural dysregulation in its pathogenesis. Here we study components the cutaneous system, including intraepidermal nerve fiber density (IENFD), mechanoreceptors, blood vessels lesional nonlesional 10 patients matched healthy controls. The mean age was 57.0±16.7 years 60% were female, identical distributions No had an neuropathy. Worst Itch Numeric Rating 8.8±1.6. Paired t-tests used to compare samples, while ANOVA control samples. Tissue processed analyze IENFD (PGP9.5), Merkel cells (cytokeratin 20), (CD31), mast cell (tryptase) immunohistochemistry. Lesional significantly lower compared (P<0.05) (P<0.001) skin. Nonlesional also (P<0.01). higher (P<0.05), vessel (13.6±0.6 vs 4.7±0.8 vessels/mm, P<0.001), counts epidermis Blood upper dermis elongated pattern that paralleled deeper dermal papillae. These findings highlight pathogenesis showing alterations structures broaden perception from dermatological condition multisystem disorder neuropathic changes as prominent feature. Therapeutics should involve neuromodulation address underlying dysregulation.