Hyperchromic and reticulated plaques in the trunk and neck of a young woman

Acute pruritic rash on a young woman after a restrictive diet

“…It usually affects young adults with a female preponderance (4-6 : 1) [1]. Mostly reported in Japanese patients, to date 15 % of the reported cases occur in Western populations [2,3]. Although the pathogenesis of PP remains unknown, multiple mechanical, inflammatory, and metabolic factors have been implicated.…”

“…Differential diagnoses (DD) are extensive due to the morphological diversity of the lesions [1][2][3][4]. At the early stage, urticaria, dermatitis herpetiformis, and linear IgA dermatosis might be considered [2][3][4], but the trunk-centered distribution and the unique reticular arrangement of individual lesions in PP allow differentiation [1,2]. An important differential diagnosis during the resolving stage is confluent and reticulated papillomatosis (CARP) [1,5,6], an idiopathic dermatosis characterized by pigmented keratotic papules with a reticular distribution over the trunk.…”

“…First-line treatment for PP includes antibiotics that inhibit neutrophil chemotaxis, such as doxycycline, minocycline and dapsone [1][2][3][4][5]8]. Of the three, minocycline appears to achieve a more rapid resolution and an effective reduction of recurrence rates [5,9].…”

“…Prurigo pigmentosa can be divided into three clinical stages [5]. Early lesions start as intensely pruritic erythematous papules across the chest, neck and upper back that acquire a symmetrical reticulated distribution [2][3][4]. Over the next 48-72 hours, fully developed lesions present as crusted erythematous papules and vesicles [6].…”

Akuter juckender Hautausschlag nach Restriktionsdiät bei einer jungen Frau

“…Vollständig entwickelte Läsionen zeigen reichlich nekrotische Keratinozyten [5,6], einige intraepidermale Neutrophile und eine intensivere Spongiose mit intraepidermaler Bläschenbildung [6], zusätzlich zu einem vorwiegend lymphozytären dermalen Infiltrat [8]. Schließlich werden epidermale Hyperplasie mit Hyperkeratose, epidermale Hyperpigmentierung und dermale Melanophagen [6][7][8] Zur Erstlinienbehandlung von PP gehören Antibiotika wie Doxycyclin, Minocyclin und Dapson, die die Chemotaxis der Neutrophilen hemmen [1][2][3][4][5]8]. Von diesen dreien scheint Minocyclin eine schnellere Remission und eine wirksame Reduktion der Rezidivraten zu erreichen [5,9].…”