Prurigo Pigmentosa

Excerpt

Prurigo pigmentosa, also known as Nagashima disease or "keto rash," is a rare inflammatory skin disease initially described by Nagashima et al in 1971. Prurigo pigmentosa typically, but not exclusively, affects young females of East Asian ethnicity, presenting as a symmetrical eruption of urticarial papules on the neck, chest, and back. The papular eruption typically coalesces into a reticulated pattern that repeatedly resolves and recurs, resulting in hyperpigmented skin of cosmetic concern. Prurigo pigmentosa can be triggered by metabolic derangements, including those secondary to ketogenic diets, which have experienced a rise in popularity in recent years. This activity reviews the proposed etiology, pathogenesis, clinical evaluation, and therapeutic management of prurigo pigmentosa and highlights the role of the interprofessional team in improving outcomes for patients with this rare dermatosis.