Betulin‐Containing Gel in the Management of a Patient With Recurrent Superinfected Wounds in Chronic Prurigo: A Case Report

ABSTRACT Chronic prurigo is frequently complicated by chronic wounds and secondary bacterial infections, representing a major therapeutic challenge. A betulin‐containing gel, approved for wound treatment in epidermolysis bullosa, has demonstrated wound‐healing and antimicrobial properties beyond its licensed indication. To describe the clinical course of a chronic, recurrently superinfected wound in chronic prurigo treated with a betulin‐containing topical gel. A 53‐year‐old male with chronic prurigo under systemic therapy with the Interleukin‐4 and ‐13 antibody Dupilumab, presented with a persistent ulcerative lesion at the mandibular angle, repeatedly colonized by pathogenic bacteria despite prior systemic and topical antimicrobial therapy. Betulin‐containing gel was applied twice daily under occlusion for 3 weeks. Clinical outcomes and microbiological findings were assessed. After 3 weeks of treatment, marked clinical improvement was observed, including reduced erythema and crusting, resolution of pain and itch, and complete epithelial stabilization. Follow‐up wound swabs were negative for pathogenic bacteria. This case suggests that betulin‐containing gel may represent a useful adjunctive treatment option for complex, superinfected chronic wounds in chronic prurigo. Further controlled studies are required to clarify its role in multimodal wound management.