Prurigo pigmentosa is a rare inflammatory
skin disease characterized by an unexpected onset of diffuse erythematous papules and macules usually on the chest, neck, and back. These generally resolve, leaving reticular
hyperpigmentation. Rarely, vesicular or bullous forms have been reported. We present a case of exfoliative vesiculobullous
prurigo pigmentosa in a 13-year-old boy. He presented with symmetrical eruption of papules and vesicles on his back, neck, and chest in the last 10 days, causing
pruritis and prickling sensation. Within a few days, the
bullous lesions and all affected areas of the skin showed exfoliation. Histological study and clinical findings indicated the condition to be vesiculobullous
prurigo pigmentosa with exfoliation. Treatment with
doxycycline 200 mg/day and topical
tacrolimus ointment showed a good response. The lesions resolved, leaving a light-brown reticulated
hyperpigmentation. In conclusion, this was a case of exfoliative vesiculobullous
prurigo pigmentosa in an adolescent man successfully treated with
doxycycline and topical
tacrolimus as an effective and safe treatment option.