Pityriasis rubra pilaris :
50-year- syrian -male had :
1- erythroderama with areas of normal skin.
2- palmoplantar hyperkeratosis
3 - scaly yellow-pink .
4-pain of joint .
elevated (E,S,R) : 50-90
Histopathology :
1-There is psoriasiform hyperplasia of the epidermis
2-orthokeratosis and parakeratosis and plugs of the follicular infundibulum
3- lymphocytic infiltrate
comment :
Pityriasis rubra pilaris is a chronic, papulosquamous skin disease of unknown etiology, classically characterized by small follicular papules, scaly yellow-pink (salmon-colored) patches, and palmoplantar hyperkeratosis. Lesions are usually symmetrical and diffuse, with areas of normal skin (islands of sparing).
In 1980, Griffiths [1] classified pityriasis rubra pilaris into five types based on age and pattern of onset as well as prognosis. Type I is classic adult type pityriasis rubra pilaris; type II is atypical adult pityriasis rubra pilaris; type III is classic juvenile pityriasis rubra pilaris; type IV is circumscribed juvenile pityriasis rubra pilaris; and type V is atypical juvenile pityriasis rubra pilaris. The classic adult type, which accounts for 50 percent of cases, has the best prognosis, with 80 percent clearing by 3 years.
a type VI pityriasis rubra pilaris, or human-immunodeficiency-virus-associated pityriasis rubra pilaris, has been described
treatment :
we treated with methotrixat 20 mg per week