Abstract
Prurigo pigmentosa is a rare inflammatory skin disorder triggered by a ketotic state, most commonly described in young women of east Asian descent. It has previously been reported in the context of diabetic ketogenesis, bariatric surgery and deliberately ketotic diets. Recently, increasing numbers of cases have been reported in the Caucasian population, possibly due to the increase in popularity of low carbohydrate diets. We present a case of a 32-year-old Caucasian man presenting with an erythematous papular eruption of the axillae, trunk and inner arms with onset on day 4 of a water fast.
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