A 55 year old female presents to the dermatology clinic for follow-up for treatment of prurigo nodularis. There are more than 20 lesions on her arms, legs, and back and the patient reports they continue to be severely itchy, and affects her quality of life and ability to sleep at night. Lab work, including CBC, CMP, HA1c, HIV, hepatitis panel and TSH/free T4 have been normal. She has not responded adequately to topical steroids, topical pramoxine, nbUVB and antihistamines. The patient is otherwise healthy. What is the mechanism of action of an FDA approved medication that can treat this patient’s prurigo nodularis?

A. Interleukin (IL) 31 inhibitor

B. Interleukin (IL) 31 activator

C. Phosphodiesterase 4 (PDE4) inhibitor

D. Inhibition of binding of TNF-alpha to its receptor

E. Binding and inhibiting interleukin (IL)-17A

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