Possible involvement of IL-31 in pruriginosa-type recessive dystrophic epidermolysis bullosa: a nemolizumab-responsive case

This case is intriguing in that selective inhibition of IL-31 led not only to rapid relief of severe pruritus but also to dramatic improvement of inflammatory skin lesions in pruriginosa-type RDEB. While IL-31 is well recognized as a central mediator of itch, this clinical course suggests that IL-31 functions as a disease-amplifying switch linking immune activation, scratching behavior, and cutaneous damage. Interrupting this pathway appeared to collapse the itch–scratch cycle itself, resulting in sustained clinical improvement beyond symptomatic itch control.