Shawn Kwatra, MD: Making the Connection Between Prurigo Nodularis, Atopic Dermatitis, and Itch

At the 44th Annual Fall Clinical Dermatology Conference in Las Vegas, a talk was given titled ‘Making the Connection Between Prurigo Nodularis, Atopic Dermatitis, and Itch.’ The presentation was given by several speakers, 1 of whom was Shawn Kwatra, MD.

Kwatra is known for his work as Johns Hopkins University School of Medicine associate professor of dermatology. Kwatra discussed several subjects with the HCPLive editorial team, the first of which was the ways in which prurigo nodularis and atopic dermatitis are connected in terms of their underlying mechanisms, particularly related to chronic itch.

“For example, in atopic dermatitis, you have many eczematous lesions and in prurigo nodularis, you have these fibrotic nodules,” Kwatra explained. “What we know is the morphology of these lesions is oftentimes genetically encoded, so you may be genetically predisposed to have a nodule or an eczematous lesion, but there's elements of shared pathophysiology. So IL-4, IL-13, and IL-31, many of these similar cytokines are conserved between these different diseases.”

He added that this shared pathophysiology has led to the approval of dupilumab, for example, for both indications.

“There are other agents like nemolizumab, which is already approved for prurigo nodularis and going to get approval for atopic dermatitis as well,” Kwatra said. “We know that shared pathophysiology is really important in advancing our understanding of these itch disorders.”

Kwatra was later asked about the latest advancements or therapies that have shown promise in managing the chronic itch seen in both prurigo nodularis and eczema. He was asked which he would say are most important for dermatologists to take note of currently.

“The latest advancements in atopic dermatitis are a whole host of novel targeted therapeutics,” Kwatra said. “We have nonsteroidal topical therapies, topical PDE4-inhibitors, topical JAK inhibitors, and aryl hydrocarbon modulators. So we have targeted topical therapeutics that are going to change how we treat these patients, not necessarily having that reliance we've had for so long on topical steroids.”

He also highlighted a recent explosion of new biologics targeting interleukin (IL)-4 receptor alpha, as well as IL-13 and IL-31 on the horizon.

To find out more about this presentation from the conference, view the full interview above. For additional information on related topics, view our latest conference coverage here.

The quotes implemented in this summary were edited for the purposes of clarity.