A weird, itchy rash is linked to the keto diet—but no one knows why
摘要
一名20岁台湾男子因肩部和胸部出现不明皮疹就医，症状包括红肿、瘙痒及伴随的色素沉着。皮肤活检显示细胞间水肿和血管周围炎症，但未发现常见皮肤病特征。医生通过询问饮食史发现，该男子在皮疹出现前一个月开始执行生酮饮食，这种高脂肪、极低碳水化合物的饮食模式迫使身体从消耗葡萄糖转为消耗脂肪。目前皮疹与生酮饮食的关联机制尚不明确。
A 20-year old man in Taiwan went to a dermatology clinic for a strange rash that had developed across his shoulders and chest. The raised, red, and itchy condition had been bothering him for a full month. By this point, he had also developed patches of pigmented skin interlaced with the red rash.
According to a case report in the New England Journal of Medicine, a skin biopsy showed swelling between his skin cells and inflammation around blood vessels, but testing came up negative for other common signs of skin conditions, leaving doctors with few leads. The doctors ultimately came to a diagnosis not by analyzing his skin further but by hearing about his diet.
The man's chest and shoulders, showing his rash and hyperpigmentation. Credit: New England Journal of Medicine, 2026The man told doctors that two months prior to his clinic appointment—a month before his rash developed—he had switched to a ketogenic diet, which is a high-fat but very low-carbohydrate eating pattern. This diet forces the body to shift from using glucose (sugar derived from carbohydrates) as an energy source to fat instead.
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