Volume 215 - Issue 3
Prurigo pigmentosa: the “keto rash”
Authors: Blake P Mumford and Anita Lasocki
Med J Aust 2021; 215 (3): 108-108.e1. || doi: 10.5694/mja2.51162
Published online: 2 August 2021
Published online: 2 August 2021
A 29-year-old Korean woman
presented with a pruritic,
reticulate, red-brown, papular
eruption overlying her clavicle and neck, occurring in the setting of carbohydrate restriction
A 29‐year‐old Korean woman presented with a pruritic, reticulate, red‐brown, papular eruption overlying her clavicle and neck, occurring in the setting of carbohydrate restriction (Figure, A and B). Medical history included polycystic ovarian syndrome, impaired fasting glucose, and anorexia nervosa (in remission). Biopsy revealed non‐specific changes and a clinical diagnosis of prurigo pigmentosa was made. Rapid resolution occurred with minocycline and re‐introduction of complex carbohydrates.
Prurigo pigmentosa is a rare inflammatory dermatosis usually seen in Japanese women and associated with ketosis.1,2 Misdiagnosis as eczema is common; unlike eczema, it does not respond to topical corticosteroids.1 A reticular rash affecting the upper torso could represent prurigo pigmentosa, particularly in the context of increasingly popular ketogenic diets.
Competing interests
No relevant disclosures.
References
- Michaels JD, Hoss E, Dicaudo DJ, Price H. Prurigo pigmentosa after a strict ketogenic diet. Pediatr Dermatol 2015; 32: 248–251.
- Beutler BD, Cohen PR, Lee RA. Prurigo pigmentosa: literature review. Am J Clin Dermatol 2015; 16: 533–543.
Provenance: Not commissioned; externally peer reviewed.