To the Editor: Prurigo pigmentosa is a rare inflammatory dermatosis first reported in Japan in 1971. Typical lesions of prurigo pigmentosa are erythematous papules with a reticular arrangement that quickly resolve leaving pigmentation. As a rare manifestation, bullous prurigo pigmentosa has been reported in cases[1,2] and case series.[3] We herein describe a case of prurigo pigmentosa with vesiculobullous formation following a ketogenic diet.
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