What to expect from dupilumab therapy for prurigo nodularis

Prurigo nodularis causes intensely itchy, firm bumps that can be maintained by repeated scratching. Dupilumab changes selected immune signals involved in type 2 inflammation, helping reduce the inflammatory drive behind the itch. Your clinician will explain the injection schedule, whether the first dose is given at the clinic, and how to store and use later doses if home administration is suitable.

Improvement is assessed over follow-up visits rather than by one isolated day. Itching may ease before every nodule has flattened, and treated skin can still show marks after active inflammation settles.

Tell your dermatologist about eye problems, parasitic infections, asthma medicines, pregnancy or breastfeeding, and every prescription or non-prescription product you use. Keep appointments so the response and injection technique can be reviewed. Continue the agreed skin-care plan, avoid picking, and use gentle cleansing and moisturising to reduce friction.

Record changes in itch, sleep, new nodules, and injection-site reactions. Do not change the dose or stop treatment without discussing it with the prescribing team.

Contact your clinician promptly for persistent eye redness, eye pain, vision changes, worsening facial swelling, or a new rash that concerns you. Seek urgent help for trouble breathing, swelling of the lips or tongue, faintness, or rapidly spreading hives after an injection. A painful, warm, draining nodule may need assessment for infection.

Ask which injection schedule applies to you, how you will recognise a meaningful response, what to do after a missed dose, and whether your other itch treatments should continue. Clarify injection storage, disposal of sharps, and which eye symptoms require same-day advice.