Prurigo Pigmentosa with Positive Direct Immunoflurescence: A Rare Case Report in Thailand

Authors

  • Oraya Pochanapan Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
  • Chuda Rujitharanawong Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Keywords:

Prurigo pigmentosa, Direct immunofluorescence, Keto rash

Abstract

Prurigo pigmentosa is a rare inflammatory dermatosis characterized by recurrent symmetrical erythematous papules that coalesce into reticulate hyperpigmentation. The lesions occur symmetrically on the back, trunk, and neck, which had profound pruritus. It is commonly reported in young women, especially in East Asia. Clinical and histopathological assessments are used to make the diagnosis that vary from early to late lesions. Most patients do not show positive direct immunofluorescence, except for only one case report. We report a 24-year-old Thai woman with an ill-defined erythematous plaque on her back and chest wall with pruritus for 3 weeks which direct immunofluorescence showed positive immunoglobulin M at superficial blood vessels and complement 3 with focal granular pattern at dermo-epidermal junction.

References

Mufti A, Mirali S, Abduelmula A, et al. Clinical manifestations and treatment outcomes in prurigo pigmentosa (Nagashima disease): A systematic review of the literature. JAAD Int 2021;3:79-87.

Alshaya MA, Turkmani MG, Alissa AM. Prurigo pigmentosa following ketogenic diet and bariatric surgery: A growing association. JAAD Case Rep 2019;5:504-7.

Kita K, Kurokawa I, Hayashi D, Hashimoto T. Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report. Front Med (Lausanne) 2022;9:1047870.

Almaani N, Al-Tarawneh AH, Msallam H. Prurigo Pigmentosa: A Clinicopathological Report of Three Middle Eastern Patients. Case Rep Dermatol Med 2018;2018:9406797.

Böer A, Misago N, Wolter M, Kiryu H, Wang XD, Ackerman AB. Prurigo pigmentosa: a distinctive inflammatory disease of the skin. Am J Dermatopathol 2003;25:117-29.

Dijkstra JWE, Bergfeild WF, Tayloar JS, et al. Prurigo Pigmentosa. Int J Dermatol 1987;26:379-81.

Teraki Y, Shiohara T, Nagashima M, Nishikawa T. Prurigo pigmentosa: role of ICAM-1 in the localization of the eruption. Br J Dermatol 1991;125:360-3.

Sung KH, Lee SK. Prurigo Pigmentosa: Clinicopathologic Study and Expression of ICAM-1. Ann Dermatol 2004;16:153-62.

Houriet C, Perruchoud DL, Beltraminelli H, Borradori L. Prurigo Pigmentosa in White Monozygotic Twins. JAMA Dermatology 2017;153:353-4.

Wong M, Lee E, Wu Y, Lee R. Treatment of Prurigo Pigmentosa with Diet Modification: A Medical Case Study. Hawaii J Med Public Health 2018;77:114-7.

Downloads

Published

2025-01-29

How to Cite

Pochanapan, O., & Rujitharanawong, C. (2025). Prurigo Pigmentosa with Positive Direct Immunoflurescence: A Rare Case Report in Thailand. Thai Journal of Dermatology, 41(1), 24–27. retrieved from https://he02.tci-thaijo.org/index.php/TJD/article/view/266906

Issue

Section

Case Report