# Clinical Presentation and Treatment of a Patient With Prurigo Pigmentosa

## TL;DR

A young man developed a rare skin condition called prurigo pigmentosa after starting a ketogenic diet, which was successfully treated with minocycline and stopping the diet.

## Contribution

This case highlights a potential link between ketogenic diets and prurigo pigmentosa and demonstrates successful treatment with oral minocycline.

## Key findings

- Prurigo pigmentosa was diagnosed in a patient following a ketogenic diet and intermittent fasting.
- Treatment with oral minocycline and discontinuation of the diet resulted in complete resolution of symptoms.
- The condition did not recur after treatment and dietary changes.

## Abstract

Prurigo pigmentosa is a rare inflammatory condition whose exact etiology is unknown; however, it is often misdiagnosed as eczema, contact dermatitis, or confluent and reticulated papillomatosis. A healthy 18-year-old male presented to the clinic with prurigo pigmentosa that developed after starting a ketogenic diet and intermittent fasting. The diagnosis was based on clinical and histopathologic findings. Treatment with oral minocycline and discontinuation of the diet led to complete resolution with no subsequent recurrence.