Hi Malinda, glad you found us. It is because "Puritus" is not a disease but a symptom; an intense sensation of itch, as after a bug bite or poison ivy exposure, so PN may cause puritus ( itch) and Puritus may initate PN and or Lichen Simplex Chronicus( skin thickening bumps) and or a host of infections from repetative scratching. Our fingernails are hotels for nasty bacteria, especially long nails with old chipped nail polish as they are hot beds and high rises for biologic bad boys carrying friends with them from lesion to lesion. When one lesion itchs we scratch it and we wake up nerve endings connected to it the they itch; they become inflamed and itch and they can even on appear on the same place on the corresponding limb on the other side of the body and a nodule will appear. Like Quantum physics, not sure how it does but it happens.

Great wording in normal terms Mitch, thank you!