Prurigo Simplex or “Itchy Red Bump” Disease: Review and Case Series


  • Joanna Wallengren Department of Clinical Sciences Lund, Dermatology and Venereology, Lund University, Lund Sweden and Skane University Hospital, SE-221 85 Lund, Sweden



prurigo simplex, itchy red bump disease, chronic prurigo, pruritus, itch, immunosuppressants


Prurigo simplex or “itchy red bump” disease is a controversial pruritic papular eruption. The objective of this study was to delineate the diagnostic criteria for this disease. A PubMed search was performed for: “prurigo simplex”, “prurigo simplex subacuta”, “subacute prurigo”, “chronic papular dermatitis in adults” and “itchy red bump disease”. Medical charts of patients with prurigo diagnoses in a university setting were analysed. The literature search revealed 32 relevant studies (431 patients) on different aspects of the disease. Out of 50 patients with prurigo diagnoses, 5 patients (4 women, mean age at onset 54 years) matched the description in literature. Small, severely itchy papules without secondary skin lesions continued to appear for years (mean 5.6 years). Skin biopsies revealed lymphocytic perivascular infiltrates, few eosinophils and occasionally spongiosis. Treatment with long-term metho­trexate or cyclosporine cleared the symptoms. Some major and minor diagnostic criteria for prurigo simplex are proposed and compared with chronic prurigo.


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Kogoj F. Urticaria, strophulus, prurigo, pruritus. In: Jadassohn J, editor. Handbuch der Haut und Geschlechtskrankheiten: Ergänzungswerk vol II/1. Berlin: Springer Verlag, 1962: p. 475–544.

Wallengren J. Prurigo: diagnosis and management. Am J Clin Dermatol 2004; 5: 85–95.

Pereira MP, Steinke S, Zeidler C, Froner C, Riepe C, Augustin M, et al. European Academy of Dermatology and Venereology European prurigo project: expert consensus on the definition, classification and terminology of chronic prurigo. J Eur Acad Dermatol Venereol 2018; 32: 1059–1065.

Kocsard E. The problem of prurigo. Aust J Dermatol 1962; 6: 156–166.

Pereira MP, Ständer S. How to define chronic prurigo? Exp Dermatol 2019; 28: 1455–1460.

Ackerman AB. Superficial perivascular dermatitis. In: Histologic diagnosis of inflammatory skin disease. Philadelphia: Lea & Febiger, 1978; 18, p. 4.

Greither A. Pruritus und prurigo. Hautarzt 1980; 31: 397–405.

Pereira MP, Hoffmann V, Weisshaar E, Wallengren J, Halvorsen JA, Garcovich S, et al. Chronic nodular prurigo: clinical profile and burden. A European cross-sectional study. J Eur Acad Dermatol Venereol 2020; 34: 2373–2383

Ollech A, Hodak E, David M, Trattner A, Didkovsky E, pavlovsky L. Idiopathic papular dermatitis in the spectrum of chronic papular eruptions (subacuta prurigo): reappraisal and diagnostic algorithm. Dermatology 2019; 235: 205–212.

Uehara M, Ofuji S. Primary eruption of prurigo simplex subacuta. Dermatologica 1976; 153: 49–56.

Sherertz EF, Jorizzo JL, White WL, Shar GG, Arrington J. Papular dermatitis in adults: subacute prurigo, American style? J Am Acad Dermatol 1991; 24: 697–702.

Rosen T, Algra RJ. Papular eruption in black men. Arch Dermatol 1980; 116: 416–418.

Chang SN, Kim SC, Chun YS, Kim KT, Ahn SK, Park WH. Chronic pruritic papular dermatitis in adult men: a variant of prurigo. J Dermatol 1999; 26: 442–447.

Sakurai Y, Matsui H, Izaki S, Kitamura K. Grouping prurigo: report of cases. J Dermatol 2001; 28: 75–80.

Gambichler T, Skrygan, A Werries A, Scola N, Stücker M, Altmeyer P, Kreuter A. Immunophenotyping of inflammatory cells in subacute prurigo. J Eur Acad Dermatol Venereol 2011; 25: 221–226.

Tritsch H, Kantner M. Neurohistological studies in subacute prurigo simplex. Arch Dermatol Res 1963; 217; 355–362.

Torchia D, Caproni M, Cozzani E, Ketabchi S, Fabbri P. Subacute prurigo-like linear IgA disease. Int J Dermatol 2007; 46: 1101–1103.

Schmidt E, Sitaru C, Schubert B, Wesselmann U, Kromminga A, Bröcker EB, Zillikens D. Subacute prurigo variant of bullous pemphigoid: autoantibodies show the same specificity compared with classic bullous pemphigoid. J Am Acad Dermatol 2002; 47: 133–136.

Wever S, Rank C, Hornschuh B, Hashimoto T, Nishikawa T, Bröcker EB, Zillikens D. Bullöses Pemphigoid unter dem Bild einer Prurigo simplex subacuta. Hautarzt 1995; 46: 789–795.

Mali JWH. Prurigo simplex subacuta: a group of cases with atopic background. Acta Derm Venereol 1967; 47: 304–308.

Bergner T, Füsgen I: Prurigo simplex subacuta. Akt Dermatol 1990; 16: 221–225.

Topal SG, Karakuş G, Karaman BF, Yücel A, Aksungur VL. The value of etiological tests and skin biopsy in the management of prurigo simplex subacuta. Acta Dermatovenerol Croat 2017; 25: 276–278.

Seikowski K, Frank U. Role of psychosomatic factors in the development and course of prurigo simplex subacuta. Dermatol Psychosom 2003; 4: 72–78.

Clark AR, Jorizzo JL, Fleischer AB. Papular dermatitis (subacute prurigo, “itchy red bump” disease): pilot study of phototherapy. J Am Acad Dermatol 1998; 38: 929–933.

Gambichler T, Hyun J, Sommer A, Stücker M, Altmeyer P, Kreuter A. A randomised controlled trial on photo(chemo)therapy of subacute prurigo. Clin Exp Dermatol 2006; 31: 348–353.

Freitag M, von Kobyletzki G, Pieck C, Altmeyer P. Balneophotochemotherapie der prurigo simplex subacuta. Der Hautarzt 1999; 344–349.

Streit V, Thiede R, Wiedow O, Christophers E. Foil bath PUVA in the treatment of prurigo simplex subacuta. Acta Derm Venereol 1996; 76: 319–320.

Moustafa FA, Sandoval LF, Jorizzo JL, Huang WW. Systemic treatment of papular dermatitis: a retrospective study. J Dermatolog Treat 2015; 26: 431–434.

Daudén E, García-Díez A. Severe resistant subacute prurigo successfully controlled by long-term cyclosporin. J Dermatolog Treat 2003; 14: 48–50.

Tokura Y, Yagi H, Hanaoka K, Ito T, Towyama K, Sachi Y, et al. Subacute and chronic prurigo effectively treated with recombination interferon-gamma: implications for participation of Th2 cells in the pathogenesis of prurigo. Acta Derm Venereol 1977; 77: 231–234.

Jorizzo JL, Gatti S, Smith EB. Prurigo: a clinical review. J Am Acad Dermatol 1981; 4: 723–728.

James WD, Berger TG, Elston DM, Neuhaus IM. Andrews’ diseases of the skin. Philadelphia: Elsevier, 2016: p 51.

Vaalasti A, Suomalainen H, Rechardt L. Calcitonin gene-related peptide immunoreactivity in prurigo nodularis: a comparative study with neurodermatitis circumscripta. Br J Dermatol 1989; 120: 619–623.

Bobko S, Zeidler C, Osada N, Riepe C, Pfleiderer B, Pogatzki-Zahn E, et al. Intraepidermal nerve fibre density is decreased in lesional and inter-lesional prurigo nodularis and reconstitutes on healing of lesions. Acta Derm Venereol 2016; 96: 404–406.

Wallengren J, Sundler F. Brachioradial pruritus is associated with a reduction in cutaneous innervation that normalizes during the symptom-free remissions. J Am Acad Dermatol 2005; 52: 142–145.

Ständer S, Pereira MP, Berger T, Zeidler, C, Augustin M, Bobko S, et al. IFSI-Guideline on Chronic Prurigo including Prurigo nodularis. Itch 2020; 5: e42.

Fowler E, Yosipovitch G. A new generation of treatments for itch. Acta Derm Venereol 2020; 100: adv00027.

Holm JG, Agner T, Sand C, Thomsen SF. Dupilumab for prurigo nodularis: Case series and review of the literature. Dermatol Ther 2020; 33: e13222.

Wallengren J. Neurokinin-1 and cytokine receptors as targets for therapy of chronic prurigo. J Eur Acad Dermatol 2019; 33: 2221–2222.

Park K, Mori T, Nakamura M, Tokura Y. Increased expression of mRNAs for IL-4, IL-17, IL-22 and IL-31 in skin lesions of subacute and chronic forms of prurigo. Eur J Dermatol 2011; 21: 135–136.

Ständer S, Yosipovitch G, Legat FJ, Lacour JP, Paul C, Narbutt J, et al. Trial of nemolizumab in moderate-to-severe prurigo nodularis. N Engl J Med 2020; 382: 706–716.

Pazdrak K, Stafford S, Alam R. The activation of the Jak-STAT 1 signaling pathway by IL-5 in eosinophils. J Immunol 1995; 155: 397–402.

Guttman-Yassky E, Silverberg JI, Nemoto O, Forman SB, Wilke A, Prescilla R, et al. Baricitinib in adult patients with moderate-to-severe atopic dermatitis: A phase 2 parallel, double-blinded, randomized placebo-controlled multiple-dose study. J Am Acad Dermatol 2019; 80: 913–921.e9.


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How to Cite

Wallengren, J. (2021). Prurigo Simplex or “Itchy Red Bump” Disease: Review and Case Series. Acta Dermato-Venereologica, 101(9), adv00539.