Other conditions can mimic prurigo pigmentosa
Urticaria presents as individual lesions that often have a pale center. The lesions may occur anywhere on the body and generally last less than 24 hours. History may reveal a trigger including drugs, infection, food, or emotional stress in up to 50% of cases.5
Irritant contact dermatitis often is associated with a stinging or burning sensation. Irritant and allergic contact dermatitis may have a geometric, or “outside job,” distribution suggestive of external contact, potentially with plants, alkalis, acids, or solvents.5
Confluent and reticulated papillomatosis is a rare asymptomatic dermatosis of unknown etiology that presents as hyperpigmented papules on the upper trunk, neck, and axillae. Most patients lack associated pruritis which is in contrast to prurigo pigmentosa.6
Pityriasis rosea is a viral exanthem that may be associated with constitutional symptoms and often presents initially with a herald patch progressing to a classic “Christmas tree” distribution with a fine collarette of scale. It often is asymptomatic, although some cases may be pruritic.5
Treatment focuses on dietary modification
Primary treatment includes resumption of a normal diet. This often leads to rapid resolution of pruritis. Residual hyperpigmentation may take months to fade.
Continue to: Pharmaceutical intervention may be necessary