Prurigo Pigmentosa Following Bariatric Surgery: A Comprehensive Clinicopathological Review

Prurigo pigmentosa (PP) is a rare inflammatory dermatosis first described in 1971 by Nagashima, classically predominantly affecting young women, particularly those of East Asian descent. Clinically, PP presents with pruritic, erythematous papules, which eventually form a reticulated pattern and resolve into post-inflammatory hyperpigmentation. The exact pathogenesis of PP remains unclear, but it is frequently linked to ketosis-inducing conditions, including strict dieting, fasting, and metabolic changes, such as those observed in diabetic ketoacidosis or anorexia nervosa. In recent years, PP has been increasingly reported in patients undergoing bariatric surgery, likely due to the rapid weight loss and subsequent ketosis that often follow these procedures. This review aims to take a closer and deeper look at the emerging connection between PP and bariatric surgery, particularly laparoscopic sleeve gastrectomy.