Papular dermatitis in adults: subacute prurigo, American style?

Determining the best treatment for recurrent pruritic papular eruptions that do not fit well into a diagnosis (of either atopy or some other diagnosis) is sometimes frustrating. We have studied 12 patients with recurrent pruritic papular eruptions by obtaining extensive histories and by performing skin biopsies, immunofluorescence studies, and screening patch tests. The eruptions in this group are not atopic by strict criteria but have atopic features and are without a determinable exogenous cause. Histologic features resemble papular urticaria, but there is no history to suggest arthropod bites. Patients with this type of eruption have features similar to those with subacute prurigo, and they respond to variable combinations of topical or systemic corticosteroids, systemic antihistamines, and UVB or UVA. We suggest that the designation of subacute prurigo might be more appropriate for patients with these findings.