Le prurigo atopique - à propos de trois observations

In 2002, we described a new clinical entity: atopic prurigo. We present three cases herein. This type of prurigo is more frequent in atopic subjects. It covers the entire body - though not the face - in the form of multiple vesicular papules that are very itchy and often nodular. These vesicular papules are often grouped in the waist, wrist and ankle regions. The lesions sometimes develop into nummular eczema. The prurigo becomes chronic and resistant to standard treatments, occasionally with severe impairment of patient quality of life. It is related to delayed-type hypersensitivity to house-dust mites, either through direct contact or through inhalation. We used two different types of test: traditional patch-tests and prick-tests under transparent occlusive film, named “prick- and patch-tests” that are more specific. Read at 30 minutes, then 48 and 96 hours respectively, they confirm the presence of a delayed-type allergy. Specific immunotherapy, based on clinical and atopic criteria, proved efficient in all three cases within the first few months. We consider atopic prurigo to be a “clinical form” of atopic dermatitis with delayed hypersensitivity to house-dust mites.