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Bullous prurigo pigmentosa and diabetes
1Department of Dermatology School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan.
Abstract:
Prurigo pigmentosa (PP) is a type of inflammatory dermatosis characterized by pruritic, reddish, papular lesions that normally resolve while leaving gross reticular pigmentation. In severe cases however, they may form edematous infiltrative plaques, but no formation of vesicles or bullae is generally found. We herein present the case of a 32-year-old Japanese male patient with diabetes mellitus, who developed a severe vesicular formation. Minocycline was found to be very effective. In addition, the eruption subsided when the urine glucose and ketone levels were controlled by glibenclamide. The most characteristic feature in this case was the fact that numerous vesicles and bullae were seen both in the beginning and throughout the clinical course. It therefore seems that a sudden exacerbation of diabetes mellitus was associated with a severe formation of vesicles and bullae. The findings of this case may suggest a correlation between diabetes mellitus and PP.
Insights
Prurigo pigmentosa (PP) typically presents with itchy, red lesions. This case highlights a severe PP variant with vesicles and bullae, potentially linked to uncontrolled diabetes mellitus.
Area of Science:
- Dermatology
- Endocrinology
Background:
- Prurigo pigmentosa (PP) is an inflammatory skin condition known for pruritic, reddish papular lesions that typically resolve with reticular pigmentation.
- Severe cases may involve edematous plaques, but vesicle or bullae formation is uncommon.
Observation:
- A 32-year-old Japanese male with diabetes mellitus presented with a severe form of PP.
- The patient exhibited numerous vesicles and bullae throughout the clinical course, a rare presentation for PP.
Findings:
- Treatment with minocycline was effective in managing the lesions.
- The eruption subsided upon controlling urine glucose and ketone levels with glibenclamide, suggesting a link to diabetes mellitus management.
Implications:
- This case suggests a potential correlation between severe Prurigo pigmentosa, particularly with vesicular and bullous formations, and exacerbations of diabetes mellitus.
- The findings underscore the importance of glycemic control in managing certain dermatological conditions.
- This case expands the understanding of PP's clinical spectrum and potential triggers.
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