Helicobacter pylori and Prurigo Nodularis

BACKGROUND/AIMS: Numerous data have! suggested that there may be a relation ship between Helicobacter pylori (H. pylori) infection and extragastric dis eases, including dermatological pathologies. We studied some cases of Hide' s Prurigo Nodularis (NP), a very itchy skin disease of unknown origin, in o rder to asses whether there is a pathogenic correlation between PN and H. p ylori infection. METHODOLOGY: Prurigo Nodularis had been diagnosed clinically and histologic ally in 42 outpatients (27 females and 15 males with mean age of 62+/-5 yea rs). All patients were screened for H. pylori infection by esophagogastrodu odenoscopy, histologic examination and specific immuno-enzymatic determinat ion. Specific pharmacological treatment was administered to all patients wi th H. pylori infection. RESULTS: H. pylori colonization was observed in 40/42 patients examined and 32/40 patients presented some immunologic alterations. After the pharmacol ogical treatment, endoscopy and rapid urease test confirmed eradication of H. pylori in 39/40 cases; itching was greatly reduced in the latter and mic roscopic examination of repeated skin biopsies revealed an improved histolo gic picture in patients affected by PN associated with H. pylori infection. CONCLUSIONS: The concomitant presence of skin disease, H. pylori infection and immune disorders infers that there may be a pathogenic connection betwe en bacterial infection and the inflammatory alteration of PN. We believe th at the pharmacologic treatment induced remission of the skin lesions by dir ect control of H. pylori chronic infection; in fact, H. pylori may have tri ggered or enhanced the vasculitis which, in turn, may have enhanced the cli nical signs and inflammatory histologic component of PN.