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Researchers are studying the real-world effectiveness of nemolizumab in adults with moderate-to-severe Prurigo nodularis PN, a chronic skin condition. This observational study aims to assess outcomes reported by both investigators and patients over six months, focusing on how the treatment works in routine clinical practice. The study follows adults newly prescribed nemolizumab by their physicians. Participants will be observed for about 12 months while receiving treatment as part of their regular medical care. No extra visits, procedures, or lab tests beyond usual clinical practice are required. A sub-study in Germany and the UK will have some participants record their itch intensity and sleep disturbance daily for the first two weeks through remote data collection. Participants will have routine clinical visits determined by their doctors, with data collected during these visits. Researchers will assess outcomes such as the Investigator Global Assessment of chronic prurigo and patient-reported peak itch intensity at six months and up to 12 months. Sleep disturbance and prurigo activity will also be tracked. This approach allows long-term monitoring of treatment effects in a real-world setting without added study-related procedures.