Prurigo nodularis
Prurigo nodularis is a skin disease characterised by pruritic (itchy) nodules which usually appear on the arms or legs. Patients often present with multiple excoriated lesions caused by scratching. Nodules are discrete, generally symmetric, hyperpigmented, and firm. Typically, these nodules are extremely pruritic and are alleviated only by steroids.

Treatment ― OTC Drugs
Washing the lesion area with soap does not help at all and can make it worse. OTC steroid ointments may help relieve the symptoms, but they usually needs to be applied for several weeks to improve. Continuing to take antihistamines also helps relieve the itching.
#OTC steroid ointment
#OTC antihistamine

#Intralesional triamcinolone injection
      References Prurigo Nodularis 29083653 
      Prurigo nodularis is a chronic disorder of the skin that is classically seen as multiple, firm, flesh to pink colored papules, plaques and nodules commonly located on the extensor surfaces of the extremities. The lesions are very pruritic and can occur in any age group. It is commonly associated with another disease such as atopic dermatitis or any dermatoses associated with chronic pruritus. The therapeutic approach is wide-arrayed ranging from treatments that act as - potent antipruritics, immunomodulators, and neuromodulators. Treatment in an established case is prolonged and improving patient compliance with education and counseling is important.
       Treatment-resistant prurigo nodularis: challenges and solutions 30881076 
      Treatment typically relies on the use of topical or intralesional steroids, though more severe or recalcitrant cases often necessitate the use of phototherapy or systemic immunosuppressives. Thalidomide and lenalidomide can both be used in severe cases; however, their toxicity profile makes them less favorable. Opioid receptor antagonists and neurokinin-1 receptor antagonists represent two novel families of therapeutic agents which may effectively treat PN with a lower toxicity profile than thalidomide or lenalidomide.
       Chronic Prurigo Including Prurigo Nodularis: New Insights and Treatments 37717255 
      Chronic prurigo (CPG) is a neuroinflammatory, fibrotic dermatosis that is defined by the presence of chronic pruritus (itch lasting longer than 6 weeks), scratch-associated pruriginous skin lesions and history of repeated scratching.
       Prurigo Nodularis: Review and Emerging Treatments 34077168
      Prurigo nodularis is a long-lasting skin problem marked by itchy nodules. We don't know exactly what causes it, but it seems that immune and nerve issues play a role in the itch-scratch cycle. Right now, there aren't any treatments approved by the US FDA specifically for prurigo nodularis.