Diagnosis: PITYRIASIS RUBRA PILARIS
Case submitted by Dr.Azeem Alam Khan to the dermRounds community.
Clinical photograph(s) submitted for peer review and discussion.
Submitted by Dr.Azeem Alam Khan. Originally posted October 7, 2010.
See case discussion.
• Psoriasis (especially erythrodermic) • Seborrheic dermatitis • Mycosis fungoides (erythrodermic) • Drug eruption • Dermatomyositis • Lichen planus
• Characteristic orange-red scaly plaques with "islands of sparing" within areas of erythema • Classic type I (adult): cephalocaudal progression, perifollicular keratotic papules, waxy palmoplantar keratoderma • "Nutmeg grater" papules on dorsal fingers — follicular hyperkeratosis • Six subtypes (Griffiths classification): types I and III most common • Palmoplantar keratoderma: waxy, orange-colored — often first or prominent feature • May evolve to erythroderma — "skip areas" of normal skin within erythema help distinguish from psoriasis • Some cases associated with HIV — check in new-onset PRP
Tags: pityriasis, rubra, pilaris, dr.azeem alam khan