What is your approach for workup and management of prurigo nodularis?

For work up of prurigo nodularis, I generally order a CBC/diff, CMP, and TSH to assess for underlying causes of pruritus.

For management, I emphasize the importance of avoiding manipulation and suggest covering lesions with band-aids to minimize scratching. I start with topical and intralesional ster...

It is a pure clinical diagnosis for me. I typically do not do biopsies. Basic laboratory tests are helpful but they do not rule out prurigo nodularis. It is a rather straightforward diagnosis.