A 20-year-old man in Taiwan sought medical advice at a dermatology clinic due to a strange rash across his shoulders and chest that had been persistently itchy and raised for a month. Additionally, patches of pigmented skin appeared interspersed with the red rash.
According to a report in the New England Journal of Medicine, a skin biopsy revealed cellular swelling and inflammation near blood vessels. However, tests did not indicate any common skin conditions, leaving doctors without immediate answers. It was the patient's recent dietary habits that led to an eventual diagnosis.
The man disclosed that he had switched to a ketogenic diet two months prior to his clinic visit, a dietary regimen high in fats and low in carbohydrates. This diet shifts the body's energy source from glucose to fat, inducing a state known as ketosis. Here, fat tissue breaks down releasing free fatty acids, which the liver converts to acetyl-CoA. When produced in excess, this molecule can disrupt normal metabolic processes, leading to the formation of ketone bodies like acetoacetate and beta-hydroxybutyrate.
These ketone bodies enter the bloodstream, providing energy sources for various tissues, particularly the brain. Ketogenic diets have recognized clinical applications, such as managing drug-resistant epilepsy and certain rare metabolic disorders. They are also being explored for obesity and type 2 diabetes management, as well as in research on cancer metabolism and neurodegenerative diseases, including Parkinsonās and Alzheimerās diseases.