The British journal of dermatology
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Prurigo nodularis (PN) is a highly pruritic condition characterized by multiple hyperkeratotic nodules. Previous immunohistochemical studies demonstrated increased numbers of dermal nerve fibres. ⋯ Hypoplasia of epidermal sensory nerves independently of clinical parameters is a new finding in PN and suggests involvement of epidermal nerves in PN pathophysiology. To date, it cannot be ruled out that reduced IENF density is due to repeated scratching. However, the presence of hypoplasia in nonlesional PN skin suggests the presence of a subclinical small fibre neuropathy.