Prurigo Pigmentosa: A Report of Two Patients in Possible Association with Essential Fatty Acid Deficiency

Abstract

Prurigo pigmentosa is a rarely seen dermatosis with pruritic reticular erythematous lesions, generally located in the midline of the trunk. Its etiology has not yet been fully understood. The lesions were clinically compatible with prurigo pigmentosa in two male patients aged 19 and 22, who were admitted to our outpatient clinic with brown-red itchy spots on their bodies, and both were on a low-carbohydrate and low-fat diet. They were completely cured by dietary change and tetracycline treatment. A low-carbohydrate diet or ketosis is commonly seen with prurigo pigmentosa, and the disease may be regressed by diet changes. Ketone bodies are accused in the etiology of prurigo pigmentosa, but the disease is not seen in each patient with ketosis. Low carbohydrate intake or ketosis affects fatty acid metabolism. We believe that changes in fatty acid amounts or composition in the skin may probably play a role in the etiopathogenesis of prurigo pigmentosa.