2026 Clinician Corner - Prurigo nodularis en plaque resolved after a loading dose of nemolizumab

Abstract 

Prurigo nodularis is a chronic pruritic dermatosis often resistant to standard therapies. We report a patient with prurigo nodularis complicated by meralgia paresthetica who achieved complete and durable resolution of pruritus after a single loading dose of nemolizumab, an interleukin-31 receptor A (IL-31RA) antagonist. This case underscores the rapid efficacy of IL-31 blockade and highlights potential neuroimmune interplay in chronic itch disorders. 

Keywords:  Chronic pruritus; IL-13; meralgia paresthetica; monoclonal antibody; nemolizumab; neuroimmune axis; prurigo nodularis

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Faculty credentials/disclosure 

The planners and faculty for this activity have no relevant financial relationships to disclose. The authors report no funding. The patient consented to publication of this case report. 

Process

Click the "add to cart/begin" button, pay any relevant fee, take the quiz, complete the evaluation, and claim your CME credit.  You must achieve 100% on the quiz with unlimited attempts available.

  • By completing this process, you are attesting that you have read the journal article.

Expiration date:

Credit eligibility for this article is set to expire on July 1, 2027.

Learning Objectives

After completing the article, the learner should be able to:

  •  Explain the role of IL-31–mediated neural sensitization in the pathogenesis of prurigo nodularis and its implications for chronic pruritus.  

  • Apply clinical reasoning to identify patients who may benefit from IL-31 receptor blockade and recognize the potential for rapid and durable response to nemolizumab in refractory prurigo nodularis.

Key Points 

  • IL-31–mediated neural sensitization plays a central role in the pathogenesis of prurigo nodularis.  

  • Recognition of neuroimmune overlap may guide biologic selection and optimize outcomes in refractory pruritic disorders. 

  • Nemolizumab, an IL-31 receptor A antagonist, can provide rapid and durable relief even after a single loading dose.  

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Course summary
Available credit: 
  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • 1.00 American Board of Surgery (ABS) Accredited CME

    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance
Course opens: 
07/01/2026
Course expires: 
07/01/2027
Cost:
$25.00

Seo Won Cho, BS1, Helen Chen, MD2, Aaron Chen, BS1, Tarun Sontam, BS1, and Michelle Tarbox, MD2 

 

1Texas A&M University Naresh K. Vashisht College of Medicine, Dallas, Texas, USA 

2 Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA 

 

Corresponding author: Helen Chen, MD, Texas Tech University Health Sciences Center School of Medicine, 3601 4th St., Lubbock, TX 79430 (e-mail: [email protected]) 

 

The planners and faculty for this activity have no relevant financial relationships to disclose. The authors report no funding. The patient consented to publication of this case report. 

Accreditation

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation

AMA PRA Category 1 Credit™

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABS CC

Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

ABIM MOC

 Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Available Credit

  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • 1.00 American Board of Surgery (ABS) Accredited CME

    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance

Price

Cost:
$25.00
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