The ketogenic diet is popular, but it can have rare side effects like prurigo pigmentosa, a skin condition. This case report details a Romanian patient who developed this issue while on a high-fat, low-carb keto diet. If you’re on keto and notice skin changes, this study is a must-read. Learn about keto’s potential side effects, understand how to spot them, and stay safe while enjoying keto’s benefits with this research!