# Prurigo Pigmentosa Following Bariatric Surgery: A Comprehensive Clinicopathological Review

## TL;DR

This paper reviews the link between prurigo pigmentosa, a rare skin condition, and bariatric surgery, especially laparoscopic sleeve gastrectomy.

## Contribution

The paper provides a comprehensive clinicopathological review of the emerging connection between prurigo pigmentosa and bariatric surgery.

## Key findings

- PP is increasingly reported in patients after bariatric surgery due to rapid weight loss and ketosis.
- Laparoscopic sleeve gastrectomy is particularly associated with the development of PP.
- The exact pathogenesis of PP remains unclear but is linked to ketosis-inducing conditions.

## Abstract

Prurigo pigmentosa (PP) is a rare inflammatory dermatosis first described in 1971 by Nagashima, classically predominantly affecting young women, particularly those of East Asian descent. Clinically, PP presents with pruritic, erythematous papules, which eventually form a reticulated pattern and resolve into post‐inflammatory hyperpigmentation. The exact pathogenesis of PP remains unclear, but it is frequently linked to ketosis‐inducing conditions, including strict dieting, fasting, and metabolic changes, such as those observed in diabetic ketoacidosis or anorexia nervosa. In recent years, PP has been increasingly reported in patients undergoing bariatric surgery, likely due to the rapid weight loss and subsequent ketosis that often follow these procedures. This review aims to take a closer and deeper look at the emerging connection between PP and bariatric surgery, particularly laparoscopic sleeve gastrectomy.