TNF and prurigo nodularis: Penicillamine can cause AEPS, while tumor necrosis factor inhibitors, epidermal growth factor inhibitors, antivirals such as indinavir and sirolimus, and vascular endothelial growth factor inhibitors such as bevacizumab can also be a cause of APD [6]. Dermatoscopic examination can be invaluable in ruling out other differential diagnoses such as lichen planus and prurigo nodularis.