Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Dermatol. 2012 Nov;39(11):891-7. doi: 10.1111/j.1346-8138.2012.01640.x. Epub 2012 Aug 20.
Prurigo pigmentosa is a recurrent dermatosis with severe pruritus and several peculiar clinical features. Its exact etiology and pathogenesis are unclear. The aim of this study was to investigate the clinical features and chronological changes in the histopathology of prurigo pigmentosa in Korean patients and to assess the etiology of this condition. We reviewed the medical records, clinical photographs and biopsy specimens from 50 patients diagnosed with prurigo pigmentosa. Mean age at diagnosis was 23.7 years (range, 15-61 years). Prurigo pigmentosa started as urticarial papules or plaques, changing first to papulovesicles and then to reticulated brownish macules. The most frequent sites were the back and chest, especially depressed areas such as the central back and inter-mammary area. Dietary change was suspected as a cause of prurigo pigmentosa in 17 patients. Histopathologically, early-stage lesions had dermatitis herpetiformis-like features; fully-developed lesions displayed impetigo-like or acute, generalized, exanthematous, pustulosis-like features; and late lesions presented with post-inflammatory hyperpigmentation-like features. Oral minocycline, with or without dapsone, was effective in inhibiting the appearance of new lesions, but did not prevent recurrence. Prurigo pigmentosa is not rare in Korea, is apparently associated with dietary modification and preferentially involves the depressed regions of the trunk.
色素性痒疹是一种复发性皮肤病，伴有严重瘙痒和一些特殊的临床特征。其确切病因和发病机制尚不清楚。本研究旨在探讨韩国患者色素性痒疹的临床特征和组织病理学的时间变化，并评估其病因。我们回顾了 50 例诊断为色素性痒疹的患者的病历、临床照片和活检标本。诊断时的平均年龄为 23.7 岁（范围为 15-61 岁）。色素性痒疹最初表现为风团样丘疹或斑块，首先变为丘疹水疱，然后变为网状棕褐色斑疹。最常见的部位是背部和胸部，特别是中央背部和乳间区域等凹陷部位。17 例患者怀疑饮食改变是色素性痒疹的原因。组织病理学上，早期病变具有疱疹样皮炎的特征；完全发展的病变表现为脓疱疮样或急性、全身性、疹样脓疱病样特征；晚期病变表现为炎症后色素沉着样特征。口服米诺环素，联合或不联合氨苯砜，可有效抑制新病变的出现，但不能预防复发。色素性痒疹在韩国并不罕见，显然与饮食改变有关，且好发于躯干的凹陷部位。
