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Prurigo nodularis ��PN�� is a chronic pruritic dermatosis of unknown etiology, characterized by firm, symmetrically localized hyperkeratotic pruritic papules and nodules. It may cause psychological problems due to intractable itching. It has been suggested that psychological factors are closely related to the development of PN, and calcitonin gene-related peptide ��CGRP��, substance P, nerve growth factor receptor ��NGFr�� superfamily and interleukin-31 may mediate pruritus in PN. Topical application of corticosteroids ��under occlusion��, vitamin D3, capsaicin, as well as ultraviolet therapy have proven to be effective for the treatment of this disease. Oral thalidomide and cyclosporine can also improve both skin appearance and pruritus in PN.