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Prurigo pigmentosa is a rare dermatosis with unknown etiology. In some cases, systemic conditions, such as diabetes mellitus, pregnancy, and fasting were associated with prurigo pigmentosa. We report a typical case of prurigo pigmentosa associated with pregnancy in a 29-year-old female. When she was first pregnant at the age of 27, of skin lesions developed and disappeared after delivery without treatment. When the skin lesions recurred at the age of 29, we treated her with dapsone, 100 mg age of 30, the skin lesions recurred. After delivery of the second baby, the skin lesions disappeared rapidly without treatment.