Prurigo nodularis is a chronic, intensely pruritic eruption that results in excoriated papules mostly on the extensor surfaces of the arms and legs. Previous studies have indicated the condition disproportionally affects those of African descent. While the etiology has not been fully elucidated, patients with prurigo nodularis have been found to have associated comorbidities such as hypertension, renal disease, and HIV infection. This review covers the principles of work-up and diagnosis of prurigo nodularis in skin of color patients as well as management considerations in this population.