Prurigo pigmentosa following laparoscopic sleeve gastrectomy: a case report

Prurigo pigmentosa (PP) is a rare dermatological condition with an unclear, often idiopathic etiology, but recent evidence points to a potential link between the disease and metabolic changes, particularly those associated with ketosis. It typically presents as a pruritic, erythematous rash, mainly affecting the trunk and neck, and often features hyperpigmented macules and plaques. The onset of PP has been associated with various factors, including fasting, dieting, and certain metabolic disorders. A high index of suspicion is necessary for diagnosis, as its clinical appearance can be easily mistaken for other skin conditions. Treatment usually involves the use of antibiotics like minocycline to reduce inflammation, along with dietary adjustments aimed at correcting the underlying metabolic disturbances. This patient's presentation strongly suggests a relationship between PP and the metabolic state induced by bariatric surgery, highlighting the importance of considering PP in post-surgical patients.