Nagashima disease Following Bariatric Surgery: A Case Report
DOI:
https://doi.org/10.69667/lmj.2517115Keywords:
Bariatric surgery, Prurigo pigmentosa, Libyan male, Ketogenic diet.Abstract
Bariatric surgery is an effective intervention for severe obesity and related comorbidities. The global increase in obesity has led to a rise in bariatric procedures, highlighting the need for the evaluation and management of postoperative complications. These complications vary from minor issues to life-threatening events. Prurigo pigmentosa (PP), also known as Nagashima disease, is an acquired dermatological condition characterized by a markedly pruritic eruption of erythematous papules and papulovesicles on the back, neck, and chest and improved leaving macular reticulated hyperpigmentation. First described in 1971 by Japanese dermatologist Masaji Nagashima, the condition was initially observed among eight patients of Asian descent. PP has been strongly associated with ketosis and a ketogenic diet; however, its precise etiology remains unclear. The condition predominantly affects young women of Asian descent. Here, we report a case of PP in a Libyan male, which developed 13 days post-bariatric surgery. This presentation could be suggestive of a stronger relationship between PP and the metabolic state of the body. It also outlines the effectiveness of treatment options currently in use for treating PP.
تعتبر جراحة السمنة تدخلاً فعالاً للسمنة الشديدة والأمراض المصاحبة لها. وقد أدى الارتفاع العالمي في السمنة إلى زيادة في إجراءات السمنة، مما يسلط الضوء على الحاجة إلى تقييم وإدارة المضاعفات بعد الجراحة. وتتراوح هذه المضاعفات من مشاكل بسيطة إلى أحداث تهدد الحياة. الحكة الصباغية والمعروفة أيضًا باسم مرض ناغاشيما، هي حالة جلدية مكتسبة تتميز بطفح جلدي حاك بشكل ملحوظ من الحطاطات والحويصلات الحطاطية على الظهر والرقبة والصدر وتحسن تاركة فرط تصبغ شبكي بقعي. تم وصف الحالة لأول مرة في عام 1971 من قبل طبيب الأمراض الجلدية الياباني ماساجي ناغاشيما، وتمت ملاحظتها في البداية بين ثمانية مرضى من أصل آسيوي. ارتبطت الحكة الصباغية ارتباطًا وثيقًا بالكيتوزية والنظام الغذائي الكيتوني؛ ومع ذلك، لا يزال السبب الدقيق لها غير واضح. تؤثر الحالة بشكل أساسي على الشابات من أصل آسيوي. هنا، نبلغ عن حالة من الحكة الصباغية لدى رجل ليبي، تطورت بعد 13 يومًا من جراحة السمنة. قد يشير هذا العرض إلى وجود علاقة أقوى بين الحكة الصباغية والحالة الأيضية للجسم. كما يوضح أيضًا فعالية خيارات العلاج المستخدمة حاليًا لعلاج الحكة الصباغية
References
Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, Buchwald H, Scopinaro N. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obesity surgery. 2018 Dec;28:3783-94.
Nimeri A, Oviedo R, Vosburg WR, Fam J, Blalock CA, Altieri MS, et al. ASMBS statement on metabolic and bariatric surgery for beneficiaries of Centers for Medicare and Medicaid Services with a review of the literature. Surgery for Obesity and Related Diseases. 2023 Dec 1;19(12):1331-8.
Nagashima M. A peculiar pruriginous dermatosis with gross reticular pigmentation. Jpn J Dermatol. 1971;81:38-9.
Nagashima M. Prurigo pigmentosa: clinical observations of our 14 cases. The Journal of Dermatology. 1978 Apr;5(2):61-7.
Beutler BD, Cohen PR, Lee RA. Prurigo pigmentosa: literature review. American journal of clinical dermatology. 2015 Dec;16:533-43.
Almaani N, Al-Tarawneh AH, Msallam H. Prurigo pigmentosa: a clinicopathological report of three Middle Eastern patients. Case Reports in Dermatological Medicine. 2018;2018(1):9406797.
Shen A, Cheng CE, Malik R, Mark E, Vecerek N, Maloney N, et al. Prurigo pigmentosa: A multi-institutional retrospective study. Journal of the American Academy of Dermatology. 2023 Aug 1;89(2):376-8.
Oba MC, Arican CD. Clinical features and follow-up of prurigo pigmentosa: a case series. Cureus. 2022 Apr;14(4).
Altalhi ER, Azhari MS, Aljuhani SS, Baltow BA, Al Hawsawi K, Altalhi E. Prurigo Pigmentosa: A Case Report With Unusual Presentation. Cureus. 2022 Dec 6;14(12).
Böer A, Misago N, Wolter M, Kiryu H, Wang XD, Ackerman AB. Prurigo pigmentosa: a distinctive inflammatory disease of the skin. The American journal of dermatopathology. 2003 Apr 1;25(2):117-29.
Oh YJ, Lee MH. Prurigo pigmentosa: a clinicopathologic study of 16 cases. Journal of the European Academy of Dermatology and Venereology. 2012 Sep;26(9):1149-53.
Mufti A, Mirali S, Abduelmula A, McDonald KA, Alabdulrazzaq S, Sachdeva M, et al. Clinical manifestations and treatment outcomes in prurigo pigmentosa (Nagashima disease): a systematic review of the literature. JAAD international. 2021 Jun 1;3:79-87.
Togawa Y, Shinkai H, Utani A. Prurigo pigmentosa in a patient with primary biliary cirrhosis and Sjögren syndrome. The Journal of Dermatology. 2004 Oct;31(10):815-9.
Alkhouri F, Alkhouri S, Potts GA. Prurigo pigmentosa following a keto diet and bariatric surgery. Cureus. 2022 Apr;14(4).
Alshaya MA, Turkmani MG, Alissa AM. Prurigo pigmentosa following ketogenic diet and bariatric surgery: A growing association. JAAD Case Reports. 2019 Jun 1;5(6):504-7.
Abbass M, Abiad F, Abbas O. Prurigo pigmentosa after bariatric surgery. JAMA dermatology. 2015 Jul 1;151(7):796-7.
Alsebayel MM, Ghobara YA, Al-Issa A. Facial prurigo pigmentosa after bariatric surgery. Cureus. 2020 Feb;12(2).
Kafle SU, Swe SM, Hsiao PF, Tsai YC, Wu YH. Folliculitis in prurigo pigmentosa: a proposed pathogenesis based on clinical and pathological observation. Journal of Cutaneous Pathology. 2017 Jan;44(1):20-7.
Torrelo A, Azorín D, Noguera L, Hernández‐Martín A, Happle R, Requena L. Segmental prurigo pigmentosa. Pediatric Dermatology. 2014 Jul;31(4):523-5.
Liu Y, Li J, Zhou G, Wang J, Chen X, Chen S, et al. Prurigo pigmentosa: A retrospective study of 11 patients. Indian Journal of Dermatology, Venereology and Leprology. 2024 Sep 1:1-5.
Danielsen M, Pallesen K, Riber-Hansen R, Bregnhøj A. A Rare Case of Prurigo Pigmentosa in a Danish Sibling Couple. Case Reports in Dermatology. 2023 Jan 6;15(1):26-30.
Al‐Zahawi S, Saberi F, Azhari V, Kamyab K, Balighi K. A Rare Case of Prurigo Pigmentosa in Iranian Sibling Couple. Clinical Case Reports. 2025 Jan;13(1):e70121.
Houriet C, Perruchoud DL, Beltraminelli H, Borradori L. Prurigo pigmentosa in white monozygotic twins. JAMA dermatology. 2017 Mar 1;153(3):353-4.
