Clinical Outcomes of Fine Fire-Needle Row Shallow Needling for Prurigo Nodularis-Associated Pruritus: A Retrospective Controlled Study

Objective To evaluate the clinical outcomes and safety of fine fire-needle row shallow needling for prurigo nodularis-associated pruritus. Methods This retrospective controlled study included 86 patients with prurigo nodularis treated between June 2024 and June 2025. Patients received fine fire-needle row shallow needling ( n = 43) or oral ebastine tablets ( n = 43). Both groups were treated for 8 weeks and followed for 12 weeks. The primary outcome was the week-8 numerical rating scale (NRS) response rate, defined as a reduction of at least 4 points from baseline. Secondary outcomes included pruritus NRS score, nodular skin lesion composite score, investigator's global assessment score, dermatology life quality index score, sleep NRS score, traditional Chinese medicine syndrome score, recurrence, and adverse events. Results At week 8, the NRS response rate was higher in the fine fire-needle group than in the ebastine group (83.72% [36/43] vs. 23.26% [10/43], P < 0.001). The fine fire-needle group had lower pruritus NRS scores at week 8 and at 4 and 12 weeks after treatment (all P < 0.001). Week-8 secondary clinical scores were also lower in the fine fire-needle group (all P < 0.001). During follow-up, recurrence occurred in 1 of 36 responders and 2 of 10 responders, respectively ( P = 0.115). No serious adverse events were recorded. Conclusion Fine fire-needle row shallow needling was associated with greater improvement in pruritus and related clinical outcomes than oral ebastine. The procedure was generally well tolerated and warrants prospective evaluation.