Prurigo nodularis as the first manifestation of a common variable immunodeficiency

Prurigo nodularis is a rare chronic disorder of unknown aetiology, which is resistant to therapy, and is characterized by pruritic nodules. We report on a 64-year-old woman with prurigo nodularis as the first symptom of common variable immunodeficiency. After the diagnosis, our patient was treated with intravenous immunoglobulin (IVIg) (0.5 g/kg every 21 days) with improvement of the cutaneous lesions. We review the literature related to aetiopathogenesis, diagnosis and treatment of prurigo nodularis, with particular regards to its relationship to common variable immunodeficiency.