Treatment of classic pityriasis rubra pilaris

Background: Treatment of classic pityriasis rubra pilaris, which almost always progresses to a generalized erythroderma with marked, often disabling keratoderma of the palms and soles, remains problematic. Objective: Our purpose was to evaluate the results of treatment in a recent period during whic...

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Bibliographic Details
Published inJournal of the American Academy of Dermatology Vol. 31; no. 6; pp. 997 - 999
Main Author Dicken, Charles H.
Format Journal Article
LanguageEnglish
Published New York, NY Mosby, Inc 01.12.1994
Elsevier
Subjects
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Dermatology
Etretinate - administration & dosage
Etretinate - adverse effects
Etretinate - therapeutic use
Female
Follow-Up Studies
Humans
Isotretinoin - administration & dosage
Isotretinoin - adverse effects
Isotretinoin - therapeutic use
Male
Medical sciences
Methotrexate - administration & dosage
Methotrexate - adverse effects
Methotrexate - therapeutic use
Middle Aged
Photochemotherapy
Pityriasis Rubra Pilaris - drug therapy
Remission Induction
Skin involvement in other diseases. Miscellaneous. General aspects
Case study
Human
Hair
Skin disease
Treatment
Clinical management
Male
Pityriasis rubra pilaris
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Summary:Background: Treatment of classic pityriasis rubra pilaris, which almost always progresses to a generalized erythroderma with marked, often disabling keratoderma of the palms and soles, remains problematic. Objective: Our purpose was to evaluate the results of treatment in a recent period during which the retinoid group of drugs has been available. Methods: The clinical course of 75 patients with classic pityriasis rubra pilaris seen from 1982 to 1992 was reviewed. Results: Of 15 patients treated with isotretinoin, 10 had complete and 2 had partial clearing. Of six treated with etretinate, four had clearing. All eight patients treated with methotrexate had a favorable response. Other forms of treatment, including Goeckerman regimen, corticosteroids, vitamin A, and cyclosporine, were ineffective. Conclusion: Early diagnosis and early treatment with retinoids appear to offer the best chance for clearing of pityriasis rubra pilaris. If retinoids fail or cannot be used, methotrexate should be considered.
ISSN:0190-9622
1097-6787
DOI:10.1016/S0190-9622(94)70271-3