{"product_id":"2940154544297","title":"Picker Nodule, (Prurigo Nodularis) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions","description":"\u003cp\u003ePicker nodule (PN) is a skin disease featured by pruritic (itchy) nodules which normally occur on the arms or legs.\u003cbr\u003ePatients often manifest with multiple ulcerated swollen lesions caused by scratching (skin picking).\u003cbr\u003ePN is also known as Hyde prurigo nodularis, lichen corneus obtusus, prurigo nodularis.\u003cbr\u003ePatients are often tormented by their symptoms which often prove difficult to control with conventional therapy\u003cbr\u003eThe most prominent symptom is the excessive itchiness of the skin lesion which makes the patient scratch or picks at the lesion hence the name Picker nodule.\u003cbr\u003eCauses:\u003cbr\u003eAtopy or allergy\u003cbr\u003eNeurological\u003cbr\u003ePsychological\u003cbr\u003eInfection\u003cbr\u003eThe exact cause of Picker nodule is still unknown.\u003cbr\u003eSymptoms:\u003cbr\u003ePicker nodule patients are most often middle-aged to elderly.\u003cbr\u003ePatients with Picker nodule normally have symptoms of a long-standing history of severe, continual pruritus.\u003cbr\u003ePatients can reveal specific locations where they start feeling itchy and where dark-colored nodules develop soon after.\u003cbr\u003eMature nodules seldom enlarge or reduce in size.\u003cbr\u003ePicker nodule is normally bilaterally symmetrical, with nodules that are either stable or rising in number.\u003cbr\u003eThe patient's medical history may be important for several disorders:\u003cbr\u003e1. Hepatic or renal dysfunction\u003cbr\u003e2. Local injury or insult to the skin\u003cbr\u003e3. Infection\u003cbr\u003e4. HIV\/immunodeficiency\u003cbr\u003e5. Hypothyroidism\u003cbr\u003e6. Hematological malignancies\u003cbr\u003e7. Anxiety or other psychiatric conditions\u003cbr\u003eThe patient's history often shows a long list of prescribed medicines (topical and oral) which normally have caused little or no relief of symptoms.\u003cbr\u003e80% of patients have a personal or family history of atopic (allergic) dermatitis, asthma, or hay fever (compared with about 25% of the normal population).\u003cbr\u003eIn a true Picker nodule, a nodule forms before any itching begins.\u003cbr\u003eNormally, these nodules are extremely itchy (pruritic) and are alleviated only by steroids.\u003cbr\u003ePicker nodule lesions may show signs of picking of skin with flat, umbilicated, or crusted top.\u003cbr\u003eSkin Nodules or papules are:\u003cbr\u003e1. ≤2 cm in diameter.\u003cbr\u003e2. Discrete.\u003cbr\u003e3. Scaly.\u003cbr\u003e4. Symmetrical distribution.\u003cbr\u003e5. Firm.\u003cbr\u003e6. Hyper-pigmented or occasionally purpuric (blue black or blood clot).\u003cbr\u003eLesions may number from 1-2 to hundreds.\u003cbr\u003eWhen entering the examination room and while patients are describing the locations of the lesions, patients may scratch or rub the lesions rather than pointing to them.\u003cbr\u003eMany Picker nodule patients seem very anxious, worried, or even obsessed with the nodules.\u003cbr\u003eThe diagnosis is based on the doctor’s observation and the presence of itching.\u003cbr\u003eOften a skin biopsy is done to confirm the diagnosis.\u003cbr\u003eBiopsy of the lesions is advised to rule out abnormal or atypical presentations of other disease such as squamous cell carcinoma, mycobacterial infections, fungal infections and cutaneous lymphoma.\u003cbr\u003eA culture of at least one skin nodule will exclude staphylococcus infection, which has been considerably linked to atopic dermatitis\u003cbr\u003eLesion biopsies will normally show a high level of eosinophils (cause of allergy) in PN.\u003cbr\u003eTreatment\u003cbr\u003ePresent available treatments of Picker nodule have had mild-to-moderate success at best.\u003cbr\u003eTopical, oral, and intra-lesional corticosteroids have all been given to reduce inflammation and sense of itching and to soften and smooth out firm nodules.\u003cbr\u003ePulsed dye laser may decrease the vascularity of individual lesions\u003cbr\u003eCryotherapy with liquid nitrogen helps to decrease pruritus and flatten lesions\u003cbr\u003eCognitive behavioural therapy\u003cbr\u003eHabit reversal therapy\u003cbr\u003eMedicines used:\u003cbr\u003eAntihistamines\u003cbr\u003eThalidomide\u003cbr\u003eLenalidomide\u003cbr\u003eOpiate-receptor antagonists\u003cbr\u003eSystemic retinoids\u003cbr\u003ePsoralen combined with ultraviolet A (PUVA) treatment\u003cbr\u003eThe immunomodulators tacrolimus and pimecrolimus\u003cbr\u003eAnxiolytic drugs\u003c\/p\u003e\u003cp\u003eTABLE OF CONTENT\u003cbr\u003eIntroduction\u003cbr\u003eChapter 1 Picker Nodule\u003cbr\u003eChapter 2 Causes\u003cbr\u003eChapter 3 Symptoms\u003cbr\u003eChapter 4 Diagnosis\u003cbr\u003eChapter 5 Treatment\u003cbr\u003eChapter 6 Prognosis\u003cbr\u003eChapter 7 Psoriasis\u003cbr\u003eChapter 8 Skin Wart\u003cbr\u003eEpilogue\u003c\/p\u003e","brand":"Kenneth Kee","offers":[{"title":"Default Title","offer_id":47103617007856,"sku":"2940154544297","price":2.99,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0737\/7593\/9824\/files\/2940154544297_p0.jpg?v=1764070563","url":"https:\/\/shop-qa.barnesandnoble.com\/products\/2940154544297","provider":"Barnes \u0026 Noble (DEV)","version":"1.0","type":"link"}