When is steroid injection recommended for prurigo nodularis?

Prurigo nodularis causes firm, itchy nodules that can become thicker through repeated scratching or rubbing. An intralesional steroid places anti-inflammatory medicine into a chosen nodule. A dermatologist may consider this approach when a small number of nodules are especially thick, inflamed, or disruptive, while also treating the wider itch and scratch cycle.

The injection treats a selected lesion rather than every possible cause of itching. The clinician may examine the skin for infection, eczema, medication reactions, or another condition and may combine local treatment with moisturising, itch control, protective dressings, or other prescribed options.

Tell the clinician about skin infections, allergies, steroid reactions, medicines, and any new nodules. Avoid squeezing or breaking the surface. After treatment, keep the site as directed and monitor for increasing redness, warmth, drainage, severe pain, or a dent or colour change in the skin. Protecting the nodule from rubbing can help reduce repeated injury.

Arrange a review if nodules multiply, become painful, bleed, ulcerate, or interfere with sleep or movement. Seek prompt care for rapidly spreading redness, pus, marked swelling, fever, or severe pain. A nodule that changes in an unusual way may need reassessment rather than repeated injections.

Ask why a particular nodule is suitable, how the injection fits your itch-control plan, and how the skin will be monitored afterward. Discuss ways to reduce scratching, whether another diagnosis needs checking, and what to do if new nodules appear.