Prurigo pigmentosa is a rare dermatosis with unknown etiology. It is characterized clinically by severe pruritic red papules and reticulate pigmentation thought to be an entity occurring more commonly in Japan where nearly 200 cases have been reported [1]. Outside Japan, only 7 cases have been described [2–7]. In Taiwan, though geographically close to Japan, no single case of this peculiar disorder has been reported. We herein describe a typical case in a Chinese and review the literatur