Prurigo Pigmentosa Successfully Treated with Low-Dose Isotretinoin

Abstract

Background/Aims: Prurigo pigmentosa (PP) is an uncommon inflammatory disease with pruritic reddish papules, papulovesicules or vesicules that are symmetrically localized on the trunk and nape, accompanied by reticular hyperpigmentation. Currently available therapeutic options seem somewhat unsatisfying. Herein, we report an 18-year-old female with PP successfully treated with low-dose isotretinoin. Methods: The patient presented with a symmetrical pruritic eruption on the lateral sides of her trunk with erythematous papules on a hyperpigmented background. Based on the typical clinical and associated histological findings, the patient was diagnosed as PP and a treatment with low-dose isotretinoin 0.3 mg/kg/day (20 mg/day) was started. Results: After a total of 3 months of 20 mg/day isotretinoin therapy, all erythematous macules and papules resolved and the residual pigmentation had almost disappeared. Conclusion: Low-dose isotretinoin is not only adequate for the improvement of erythematous lesions, it also helps resolve the reticular hyperpigmentation of PP. Further studies are needed to observe the efficacy of isotretinoin in the treatment of PP.

Prurigo pigmentosa: a clinicopathological study and analysis of associated factors

“…The most common and effective therapeutic agents for PP are minocycline, tetracycline, and doxycycline 22,29,30 . Other established treatments include sulfonamides (dapsone, sulfamethoxazole), macrolide antibiotics (clarithromycin, roxythromycin), potassium iodide, and isotretinoin 31–35 . Treatment with a mean 2.4 week course of doxycyline at a dose of 200 mg/day has been effective in most cases in initial and recurrent episodes.…”

Low dose of isotretinoin: A comprehensive review

“…After a 3‐month course, all the lesions resolved with significant reduction of posthealing residual pigmentation. Low‐dose isotretinoin was effective in improvement of erythematous lesions of PP and postlesional reticular hyperpigmentation (Akoglu, Boztepe, & Karaduman, ).…”

Prúrigo pigmentoso

“…Actú an de forma rá pida con remisió n del cuadro en semanas, pero no evitan la pigmentació n reticulada final. Se han descrito casos tratados con doxiciclina 6 , yoduro potá sico 7 , isotretinoína 8,9 , macró lidos 10 y fototerapia con UVB de banda estrecha en un caso ocurrido durante el embarazo. b i b l i o g r a f í a Figura 4 -Paciente 2: distribució n de las lesiones de prú rigo pigmentoso en la cara anterior torá cica desde la base del cuello, regió n clavicular de forma bilateral y simé trica formando la característica morfología en V en el escote.…”