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Reticular Erythema and Hyperpigmentation in a Woman

Prurigo pigmentosa (PP) is a rare inflammatory dermatosis characterised by pruritic erythematous papules and macules on the trunk in a reticular pattern, resolving with hyperpigmentation. Histopathologic presentations are nonspecific, including spongiosis and necrotic keratinocytes, perivascular neutrophilic infiltrates, and lichenoid infiltrates of eosinophils and lymphocytes. Some exogenous factors, including sweating, friction from clothing, and ketotic states (dieting, fasting, diabetes mellitus), are thought to play a role in the aetiology of PP. Topical and systemic corticosteroids are not effective while oral minocycline (100-200 mg) taken daily is the first-line therapy for PP.