Medical education Snapshot
Dermatology Metabolic diseases
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
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
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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.


Authors

  • Blake P Mumford1
  • Anita Lasocki2
  • 1. Skin Health Institute, Melbourne, VIC
  • 2. St Vincent’s Hospital, Melbourne, VIC

Correspondence: blake.mumford@indoctrinate.com.au

Competing interests

No relevant disclosures.

References

Provenance: Not commissioned; externally peer reviewed.

View this article on Wiley Online Library

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