Prurigo Pigmentosa: A Multi-Institutional Retrospective Study

August 2023 in “ Journal of the American Academy of Dermatology ”

Amy Q. Shen, Carol E. Cheng, Rhea Malik, Erica Mark, Natalia Vecerek, Nolan J. Maloney, Joan Leavens, Vinod E. Nambudiri, Art P. Saavedra, Marcia Hogeling, Scott Worswick

prurigo pigmentosa pruritus erythematous papules hyperpigmentation ketogenic diet oral antibiotics doxycycline minocycline topical corticosteroids itching red bumps skin darkening keto diet antibiotics corticosteroid creams

TLDR Prurigo pigmentosa mainly affects middle-aged White and Asian women, often linked to a ketogenic diet, and is best treated with oral antibiotics.

This multi-institutional retrospective study examined 30 patients with prurigo pigmentosa (PP) from three academic centers over a 10-year period. The study found that PP predominantly affects White and Asian females, with an average age of 41 years. All patients experienced pruritus and presented with erythematous papules and hyperpigmentation, primarily on the back and chest. A significant portion (40%) were on a ketogenic diet prior to symptom onset. The study did not find a strong association between PP and autoimmune or atopic conditions but noted a higher body mass index in nearly all patients. Oral antibiotics, particularly doxycycline and minocycline, were effective in achieving complete resolution of symptoms, whereas topical corticosteroids provided only temporary relief. The study suggests that PP may have multiple etiologies beyond the ketogenic diet.

View this study on jaad.org →