These recurring itchy lesions that self-resolve may represent prurigo nodularis, lichen planus, or a viral/inflammatory dermatosis. The chronic course and waxing-waning nature make a biopsy a reasonable next step.
Next Steps
If lesions are persistent or worsening, do proceed with the skin biopsy to confirm diagnosis. Meanwhile, apply a mild steroid cream (like fluticasone) to reduce itching, and keep skin moisturized.
Health Tips
Since symptoms are ongoing for years and disturbing sleep, it’s best to get a detailed evaluation through an online consultation with a dermatologist for targeted therapy and to rule out any systemic triggers.