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Vieira Granja B, Amoedo P, Gomes NP, Costa C, Azevedo F, Magina S. Pityriasis rubra pilaris after COVID-19 vaccination: successful treatment with ustekinumab. An Bras Dermatol 2024; 99:642-644. [PMID: 38653608 DOI: 10.1016/j.abd.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/09/2023] [Accepted: 07/10/2023] [Indexed: 04/25/2024] Open
Affiliation(s)
- Bárbara Vieira Granja
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal.
| | - Patrícia Amoedo
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Nuno Preto Gomes
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Catarina Costa
- Department of Pathology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Filomena Azevedo
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Sofia Magina
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Department of Biomedicine, Faculty of Medicine, Universidade do Porto, Porto, Portugal
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2
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Koroneos G, Nicolopoulos J, Dolianitis C. Risankizumab for the treatment of pityriasis rubra pilaris postanaplastic large cell lymphoma. JAAD Case Rep 2024; 48:108-111. [PMID: 38813065 PMCID: PMC11134539 DOI: 10.1016/j.jdcr.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Affiliation(s)
- Georgia Koroneos
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Australia
| | - Jenny Nicolopoulos
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Australia
| | - Con Dolianitis
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Australia
- Faculty of Medicine, University of Melbourne, Melbourne, Australia
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3
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Shams RB, Rubinstein DE, Sayed CJ. Surgical Management of Severe Cicatricial Ectropion Secondary to Pityriasis Rubra Pilaris. Dermatol Surg 2024:00042728-990000000-00826. [PMID: 38820437 DOI: 10.1097/dss.0000000000004258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Indexed: 06/02/2024]
Affiliation(s)
- Rayad B Shams
- University of North Carolina Chapel Hill School of Medicine, Chapel Hill, North Carolina
- Department of Dermatology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Daniel E Rubinstein
- Department of Ophthalmology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Christopher J Sayed
- Department of Dermatology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
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4
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Moledina M, Davison S, Malik A. Ophthalmic complication of pityriasis rubra pilaris. BMJ Case Rep 2024; 17:e256445. [PMID: 38806396 DOI: 10.1136/bcr-2023-256445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
Pityriasis rubra pilaris (PRP) is a rare dermatological condition which may present with ocular manifestations. We report a case of recurrent cicatricial ectropion (CE) with topical beta-blocker use in the rare dermatological condition PRP. The patient underwent release of scar tissue, lateral tarsal strip and full-thickness supraclavicular skin graft for CE following immunosuppression with methotrexate for 3 months. Postoperatively, CE recurred, with skin graft shrinkage and resumption of periocular disease activity, 8 weeks following the introduction of topical timolol. The patient was referred for further immunosuppression and substitution of timolol before consideration for further surgery. PRP has a variety of potential ocular complications. Surgery has a high risk of recurrence and should be performed when the overall disease is quiescent and drugs, which could trigger reactivation, have been discontinued and/or substituted. Skin grafts should be oversized to off-set shrinkage.
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Affiliation(s)
- Malik Moledina
- Southend University Hospital NHS Foundation Trust, Southend-on-Sea, UK
| | - Simon Davison
- Barking Havering and Redbridge University Hospitals NHS Trust, Romford, London, UK
| | - Adeela Malik
- Southend University Hospital NHS Foundation Trust, Southend-on-Sea, UK
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5
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Chandy RJ, Chokshi A, Tan I, Feldman SR. Biologics for Treatment of Pityriasis Rubra Pilaris: A Literature Review. J Cutan Med Surg 2024; 28:269-275. [PMID: 38549359 DOI: 10.1177/12034754241238735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
OBJECTIVE To describe the published efficacy and adverse event rates associated with existing biologics for the treatment of pityriasis rubra pilaris (PRP). DATA SOURCES A literature review using the PubMed database (January 1990-July 2023) was conducted. Multiple search combinations were conducted using "pityriasis rubra pilaris" and various biologics as keywords to identify relevant articles. STUDY SELECTION AND DATA EXTRACTION Inclusion criteria included all study types that were published within the past 30 years in English and mentioned at least one biologic and PRP. A preliminary search yielded a total of 499 results. After screening using inclusion and exclusion criteria, 77 relevant articles (69 case reports, 5 case series, 2 clinical trials, and 1 retrospective analysis) were analyzed. DATA SYNTHESIS TNF-α inhibitors have been evaluated and are effective in treating PRP. However, recent treatment with anti-interleukin (IL)-17 and anti-IL-23 therapies such as ustekinumab, secukinumab, and ixekizumab are emerging as new treatment options with a mean improvement in PRP Area and Severity Index scores, change in severity of erythema, scaling, and thickness of PRP lesions. From initial clinical trials, secukinumab and ixekizumab are promising treatment options for achieving remission. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE This review compares the efficacy for numerous biologics and a discussion to guide clinicians on benefits and risks in choosing a biologic for PRP patients. CONCLUSIONS Biologics may be a favourable treatment option leading to greater patient adherence due to reduced dosing frequencies, improvement in quality of life, and reduction in frequency and severity of flares.
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Affiliation(s)
- Rithi J Chandy
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Aditi Chokshi
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Isabella Tan
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Dermatology, University of Southern Denmark, Odense, Denmark
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6
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Bobotsis R, Brathwaite S, Eshtiaghi P, Rodriguez-Bolanos F, Doiron P. HIV: Inflammatory dermatoses. Clin Dermatol 2024; 42:169-179. [PMID: 38142786 DOI: 10.1016/j.clindermatol.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
Patients living with HIV may experience a variety of inflammatory dermatoses, ranging from exacerbations of underlying conditions to those triggered by HIV infection itself. This article presents a current literature review on the etiology, diagnosis and management of atopic dermatitis, psoriasis, pityriasis rubra pilaris, lichen planus, seborrheic dermatitis, eosinophilic folliculitis, pruritic papular eruption and pruritus, in patients living with HIV.
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Affiliation(s)
- Robert Bobotsis
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Shakira Brathwaite
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Panteha Eshtiaghi
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Fabian Rodriguez-Bolanos
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Philip Doiron
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada.
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7
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Joshi TP, Duvic M. Pityriasis Rubra Pilaris: An Updated Review of Clinical Presentation, Etiopathogenesis, and Treatment Options. Am J Clin Dermatol 2024; 25:243-259. [PMID: 38159213 DOI: 10.1007/s40257-023-00836-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
Pityriasis rubra pilaris (PRP) is a rare papulosquamous reaction pattern with a significant impact on quality of life. Type I PRP is the most common PRP variant, presenting as erythematous papules emerging in a follicular distribution and later coalescing into plaques with characteristic islands of sparing; histologically, an alternating pattern of orthokeratosis and parakeratosis is considered the hallmark of PRP (checkerboard hyperkeratosis). Other PRP variants (types II-V) differ in their age of onset and clinical presentation. Type VI PRP is a rare PRP subtype associated with human immunodeficiency virus infection and is occasionally associated with diseases of the follicular occlusion tetrad. Caspase recruitment domain family, member 14 (CARD14)-associated papulosquamous eruption and facial discoid dermatitis are newly described disease states that have an important clinical overlap with PRP, creating shared conundrums with respect to diagnosis and treatment. The etiology inciting PRP often remains uncertain; PRP has been suggested to be associated with infection, malignancy, or drug/vaccine administration in some cases, although these are based on case reports and causality has not been established. Type V PRP is often due to inborn CARD14 mutations. Furthermore, recent literature has identified interleukin-23/T-helper-17 cell axis dysregulation to be a major mediator of PRP pathogenesis, paving the way for mechanism-directed therapy. At present, high-dose isotretinoin, ixekizumab, and secukinumab are systemic agents supported by single-arm prospective studies; numerous other agents have also been trialed for PRP, with variable success rates. Here, we discuss updates on clinical manifestations, present new insights into etiopathogenesis, and offer a survey of recently described therapeutic options.
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Affiliation(s)
- Tejas P Joshi
- School of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
| | - Madeleine Duvic
- Department of Dermatology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
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8
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Montero-Menárguez J, Amat Samaranch V, Puig Sanz L, Ruiz-Villaverde R, Arias-Santiago S, Larrea García M, Ruiz Genao D, Ferrán M, Schneller-Pavelescu L, Romero Ferreiro C, Rivera Díaz R. Pityriasis Rubra Pilaris: A Multicentric Case Series of 65 Spanish Patients. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00161-3. [PMID: 38401879 DOI: 10.1016/j.ad.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/13/2023] [Accepted: 02/06/2024] [Indexed: 02/26/2024] Open
Abstract
INTRODUCTION PRP is a rare entity of unknown etiopathogenesis. Lack of management guidelines makes it a challenge for clinicians. OBJECTIVE To add our experience to increase evidence about PRP. METHODS We performed a retrospective, descriptive and multicentric study of 65 patients with PRP, being the largest European case series of patients with PRP. RESULTS PRP was more frequent in male patients with an average age of 51 years, but erythrodermic forms presented in older patients (average age 61 years). Six (75%) paediatric patients and ten (60%) non-erythrodermic adults controlled their disease with topical corticosteroids. On the contrary, 26 (68%) erythrodermic patients required biologic therapy as last and effective therapy line requiring an average of 6.5 months to achieve complete response. CONCLUSION Our study showed a statistical difference in terms of outcome and response to treatment between children or patients with limited disease and patients who develop erythroderma.
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Affiliation(s)
- J Montero-Menárguez
- Dermatology Department of the Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - V Amat Samaranch
- Dermatology Department of Hospital de la Santa Creu i Sant Pau de Barcelona, Spain
| | - L Puig Sanz
- Dermatology Department of Hospital de la Santa Creu i Sant Pau de Barcelona, Spain
| | - R Ruiz-Villaverde
- Dermatology Department of Hospital Universitario San Cecilio de Granada, Spain
| | - S Arias-Santiago
- Dermatology Department of Hospital Virgen de las Nieves de Granada, School of Medicine, Granada University, Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - M Larrea García
- Dermatology Department of Hospital Universitario de Navarra, Spain
| | - D Ruiz Genao
- Dermatology Department of Fundación Hospital Alcorcón, Spain
| | - M Ferrán
- Dermatology Department of Hospital del Mar de Barcelona, Spain
| | | | - C Romero Ferreiro
- Unidad de Soporte Científico, Instituto de Investigación Sanitaria, Hospital Universitario 12 de Octubre, Spain; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - R Rivera Díaz
- Dermatology Department of the Hospital Universitario 12 de Octubre, Madrid, Spain
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9
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Blicharz L, Czuwara J, Rudnicka L, Torrelo A. Autoinflammatory Keratinization Diseases-The Concept, Pathophysiology, and Clinical Implications. Clin Rev Allergy Immunol 2023; 65:377-402. [PMID: 38103162 PMCID: PMC10847199 DOI: 10.1007/s12016-023-08971-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 12/17/2023]
Abstract
Recent advances in medical genetics elucidated the background of diseases characterized by superficial dermal and epidermal inflammation with resultant aberrant keratosis. This led to introducing the term autoinflammatory keratinization diseases encompassing entities in which monogenic mutations cause spontaneous activation of the innate immunity and subsequent disruption of the keratinization process. Originally, autoinflammatory keratinization diseases were attributed to pathogenic variants of CARD14 (generalized pustular psoriasis with concomitant psoriasis vulgaris, palmoplantar pustulosis, type V pityriasis rubra pilaris), IL36RN (generalized pustular psoriasis without concomitant psoriasis vulgaris, impetigo herpetiformis, acrodermatitis continua of Hallopeau), NLRP1 (familial forms of keratosis lichenoides chronica), and genes of the mevalonate pathway, i.e., MVK, PMVK, MVD, and FDPS (porokeratosis). Since then, endotypes underlying novel entities matching the concept of autoinflammatory keratinization diseases have been discovered (mutations of JAK1, POMP, and EGFR). This review describes the concept and pathophysiology of autoinflammatory keratinization diseases and outlines the characteristic clinical features of the associated entities. Furthermore, a novel term for NLRP1-associated autoinflammatory disease with epithelial dyskeratosis (NADED) describing the spectrum of autoinflammatory keratinization diseases secondary to NLRP1 mutations is proposed.
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Affiliation(s)
- Leszek Blicharz
- Department of Dermatology, Medical University of Warsaw, 02-008, Warsaw, Poland
| | - Joanna Czuwara
- Department of Dermatology, Medical University of Warsaw, 02-008, Warsaw, Poland.
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, 02-008, Warsaw, Poland
| | - Antonio Torrelo
- Department of Dermatology, University Children's Hospital Niño Jesús, 28009, Madrid, Spain.
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10
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Armillas-Lliteras L, Iglesias-Sancho M, Altemir A, Moreno Romero JA. Pityriasis rubra pilaris induced by topical use of imiquimod 5. An Bras Dermatol 2023; 98:884-886. [PMID: 37394296 PMCID: PMC10589495 DOI: 10.1016/j.abd.2022.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 07/04/2023] Open
Affiliation(s)
- Lucia Armillas-Lliteras
- Department of Dermatology, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, Spain.
| | - Maribel Iglesias-Sancho
- Department of Dermatology, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, Spain
| | - Arcadi Altemir
- Department of Dermatology, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, Spain
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11
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Ramesh H, Somashekhar S, Kanathur S. Lichens in dermatology. Indian J Dermatol Venereol Leprol 2023; 89:908-915. [PMID: 37067120 DOI: 10.25259/ijdvl_794_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 06/29/2022] [Indexed: 03/30/2023]
Affiliation(s)
- Heera Ramesh
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Sachin Somashekhar
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Shilpa Kanathur
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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12
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Ishikawa Y, Ajima S, Hashizume H. Pityriasis rubra pilaris with simultaneous emergence of human herpesvirus-6 reactivation in a patient with drug-induced hypersensitivity syndrome. J Dermatol 2023; 50:e368-e369. [PMID: 37469202 DOI: 10.1111/1346-8138.16877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/02/2023] [Accepted: 06/15/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Yuto Ishikawa
- Department of Dermatology, Iwata City Hospital, Iwata, Japan
| | - Sayaka Ajima
- Department of Dermatology, Iwata City Hospital, Iwata, Japan
| | - Hideo Hashizume
- Department of Dermatology, Iwata City Hospital, Iwata, Japan
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13
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Potestio L, Martora F, Villani A, Megna M, Ruggiero A. Comment on: 'Clinical characteristics of patients with pityriasis rubra pilaris following SARS-CoV-2 vaccination' by Gambichler. J Eur Acad Dermatol Venereol 2023; 37:e1196-e1197. [PMID: 37326210 DOI: 10.1111/jdv.19264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alessia Villani
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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14
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Guevara M, Mafla M, Miño C. Atypical Mal de Meleda in a Hispanic Patient. Case Rep Dermatol Med 2023; 2023:6640311. [PMID: 37744084 PMCID: PMC10513804 DOI: 10.1155/2023/6640311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/26/2023] Open
Abstract
Mal de Meleda (MDM) is a rare autosomal palmoplantar keratoderma (PPK) skin disorder (estimated incidence of 1 per 100,000 people) commonly associated with consanguinity and early childhood onset. MDM is characterized by bilateral diffusion of PPK plaques with delimited yellowish lesions that transgredien to the dorsum of the hands and feet. Additional features include nail dystrophy, lichenoid lesions, hyperhidrotic maceration, involvement of the knees and elbows, malodor, fungal superinfections, and digital constrictions. A male patient aged 42 years presented with asymptomatic, chronic, and diffused PPK lesions that progressed to the dorsal surface of the hands and feet, along with knees and elbows involvement. On clinical examination, asymmetrical lesions were observed on the hands, the left palm with yellowish waxy hyperkeratotic plaques, and the right palm with erythematous scaling and hyperkeratotic interphalangeal rings. The soles of the feet presented with yellow waxy hyperkeratotic plaques. In addition, nail dystrophy and loss of dermatoglyphics were observed. Initially, symptomatic topical treatment was established. However, owing to the lack of clinical response, a biopsy was performed, which revealed thickened corneal layer, acanthosis, spongiosis, and perivascular lymphohistiocytic infiltrate. MDM diagnosis was confirmed based on a personal history of consanguinity, clinical presentation with absence of systemic symptoms, and transgredien pattern of the lesions. Systemic treatment with low doses of isotretinoin (10 mg orally everyday) was initiated, and two months later, slight clinical improvement has been observed until date. The present case report describes MDM in a Hispanic patient, who presented with asymmetric PPK lesions on the hands and received isotretinoin treatment.
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Affiliation(s)
- Mónica Guevara
- Dermatology Service, Pablo Arturo Suarez Hospital, Ángel Ludeña y Machala Oe5261, 170702 Quito, Ecuador
| | - Michelle Mafla
- Dermatology Service, Pablo Arturo Suarez Hospital, Ángel Ludeña y Machala Oe5261, 170702 Quito, Ecuador
| | - Camila Miño
- School of Medicine, Pontifical Catholic University of Ecuador, Ave 12 de Octubre 1076, 170143 Quito, Ecuador
- Public Health, London School of Hygiene & Tropical Medicine, Keppel street, WC1E 7HT, London, UK
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15
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Abduljawad M, Alsharif TH, Gronfula AG, Magadmi TK, Khayat LI, Fageeh SM, Almuallim AA, Mohammad MA, Albadri A. The Effectiveness of Anti-Interleukin-17A Treatment for Pityriasis Rubra Pilaris: A Systematic Review. Cureus 2023; 15:e41125. [PMID: 37519579 PMCID: PMC10382908 DOI: 10.7759/cureus.41125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Anti-interleukin-17A (anti-IL-17A) therapy has been increasingly employed as a treatment option for pityriasis rubra pilaris (PRP). In this study, we reviewed all available studies on this topic in the literature to evaluate the efficacy and safety of anti-IL-17A. Our main objective was to assess the current evidence on the efficacy and safety of anti-IL-17A therapy in the management of PRP. We searched for relevant articles on PubMed, MEDLINE, Ovid, Embase, and the Web of Science electronic databases from inception until 2022. Our inclusion criteria were as follows: randomized controlled trials (RCTs), quasi-randomized trials, or prospective observational studies that include PRP patients treated with biological treatments; studies that report clinical outcomes; and studies that compare the treatment modalities, including anti-IL-17, in the English language. A total of 19 articles involving 77 cases were reviewed after applying the inclusion criteria and removing duplicates. We found that type 1 PRP was the most common condition irrespective of gender, and the trunk was the most affected area. The study showed that IL-17 inhibitors had a significant impact on the patients. However, higher-level studies are required to further evaluate the therapeutic and safety effects of the treatment.
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Affiliation(s)
| | | | - Amin G Gronfula
- Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Talah K Magadmi
- Medicine and Surgery, King Abdulaziz University, Jeddah, SAU
| | | | - Sarah M Fageeh
- Medicine, Faculty of Medicine, Umm Al-Qura University, Makkah, SAU
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16
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Al Khalifa N, Alsabbagh M, Raees M, Aljufairi E. Misdiagnosed Pityriasis Rubra Pilaris Successfully Managed With Isotretinoin: A Case Series. Cureus 2023; 15:e38657. [PMID: 37168410 PMCID: PMC10166574 DOI: 10.7759/cureus.38657] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 05/13/2023] Open
Abstract
Being a rare inflammatory, hyperproliferative dermatosis, diagnosing pityriasis rubra pilaris (PRP) can be a challenge to many clinicians. Our case reports aim to demonstrate that PRP is frequently diagnosed and managed as atopic dermatitis (AD) and that distinguishing features on dermoscopy, and biopsy can help diagnose this rare disease. The study also aims to show that PRP can be successfully treated with Isotretinoin. Our case series aims to describe two cases of PRP, initially diagnosed as AD and managed with topical corticosteroids. Being the first case series in the literature to describe the incidences of diagnosing PRP as AD portrays the significance of utilizing dermoscopy and biopsy as tools to confirm this diagnosis for appropriate management. Although PRP is a rare diagnosis, dermoscopy and biopsy can help confirm the disease. Management with isotretinoin will most likely have successful outcomes in those patients.
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Affiliation(s)
| | | | - Mazen Raees
- Dermatology, King Hamad University Hospital, Busaiteen, BHR
| | - Eman Aljufairi
- Pathology, King Hamad University Hospital, Busaiteen, BHR
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17
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Zhang LW, Wang WJ, Fu LX, Lu YH, Chen T, Xu RH. Pityriasis rubra pilaris following inactivated SARS-CoV-2 vaccine (CoronaVac). J Eur Acad Dermatol Venereol 2023; 37:e287-e288. [PMID: 36504416 DOI: 10.1111/jdv.18768] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Li-Wen Zhang
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Wen-Ju Wang
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Li-Xin Fu
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Yong-Hong Lu
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Tao Chen
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, China
| | - Rong-Hua Xu
- Institute of Dermatology, Chengdu Second People's Hospital, Chengdu, China
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18
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Saad M, Spurr A, Lipson J. Pityriasis rubra pilaris partially responsive to treatment with upadacitinib: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231160927. [PMID: 37009550 PMCID: PMC10064474 DOI: 10.1177/2050313x231160927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Pityriasis rubra pilaris is a rare inflammatory dermatosis characterized by orange-red confluent plaques, hyperkeratotic follicular papules, palmoplantar keratoderma, and, in some cases, erythroderma. The etiology of pityriasis rubra pilaris is unclear. This condition is often treated with oral retinoids and topical corticosteroids, and more recently, biological agents have become the mainstay of treatment. However, there is a paucity of high-quality evidence on the safety and effectiveness of these agents, and the disease often remains refractory to therapy. Herein, we present a case of pityriasis rubra pilaris with a favorable response to treatment with upadacitinib, a Janus kinase inhibitor, which has not been previously reported in the literature for the management of this condition.
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Affiliation(s)
- Mysa Saad
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Alison Spurr
- Division of Dermatology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Jennifer Lipson
- Division of Dermatology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
- Jennifer Lipson, Division of Dermatology, The Ottawa Hospital, University of Ottawa, 737 Parkdale Avenue, Ottawa, ON K1Y 4M9, Canada.
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19
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Balak DMW, Rissmann R. Anti-interleukin-17A for pityriasis rubra pilaris: catching the psoriasis biologic wave. Br J Dermatol 2022; 187:633-634. [PMID: 35996840 PMCID: PMC10015986 DOI: 10.1111/bjd.21813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022]
Abstract
Linked Article: Boudreaux et al. Br J Dermatol 2022; 187:650–658.
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Affiliation(s)
- Deepak M W Balak
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, Leiden, the Netherlands.,Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands
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20
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Albrakati BA, Alshareef IA, Alhawsawi WK, Al Hawsawi KA. Atypical Juvenile Pityriasis Rubra Pilaris: A Case Report of Early Onset With Late Diagnosis. Cureus 2022; 14:e30234. [DOI: 10.7759/cureus.30234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
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21
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Nishimura M, Kondo M, Habe K, Hayashi A, Yamanaka K. Successful treatment with cyclosporine and guselkumab for pityriasis rubra pilaris. Clin Case Rep 2022; 10:e6413. [PMID: 36245447 PMCID: PMC9540577 DOI: 10.1002/ccr3.6413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022] Open
Abstract
A man with pityriasis rubra pilaris (PRP) showed no improvement in skin symptoms despite treatment with several drugs. The patient was diagnosed as having type 1 PRP. Combination therapy with cyclosporine and guselkumab improved his skin condition. Here, we propose a novel therapeutic strategy for intractable PRP.
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Affiliation(s)
- Mai Nishimura
- Department of DermatologyMie University Graduate School of MedicineTsuJapan
| | - Makoto Kondo
- Department of DermatologyMie University Graduate School of MedicineTsuJapan
| | - Koji Habe
- Department of DermatologyMie University Graduate School of MedicineTsuJapan
| | - Akinobu Hayashi
- Department of Oncologic PathologyMie University Graduate School of MedicineTsuJapan
| | - Keiichi Yamanaka
- Department of DermatologyMie University Graduate School of MedicineTsuJapan
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22
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Muacevic A, Adler JR. Physiotherapy Management of an Adolescent With Pityriasis Rubra Pilaris Along With Rickets. Cureus 2022; 14:e30518. [PMID: 36415347 PMCID: PMC9674203 DOI: 10.7759/cureus.30518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/20/2022] [Indexed: 01/25/2023] Open
Abstract
Rickets is an ossification and mineralization disorder of the growth plate before skeletal maturity that is peculiar to children and adolescents. Most children are affected by this deficient disorder throughout their skeletal growth stage, characterized by deformed and soft bones, due to a failure to assimilate and utilize calcium and phosphorus properly. It is most frequent in children aged four months to three years in developing countries. In the Indian subcontinent, it continues to be a major health problem. The majority of rickets symptoms include bone pain, deformity of the bones, and impaired growth velocity. In addition to damaging the skeletal system, it also affects other systems, which results in substantial morbidity. The term "rachitic pneumopathy" has long been used to describe respiratory issues caused by rickets. Pityriasis rubra pilaris (PRP) is an inflammatory rare skin disease that affects children as well as adults of all ages. They can develop PRP's clinical characteristics and individual prognoses are quite varied. Rickets occurring in association with skin diseases is rare. Here, we report an instance of a 15-year-old boy who gave a history of pain and swelling in the knees for the past three months. He couldn't bear weight and had walking difficulty as well. Along with this, he also complained of itchy lesions for nine years. Initially, the lesions were on the right arm, which progressed to the left arm, chest, back and abdomen. Later, they were seen on the lower limbs. After appropriate diagnostic work, he was diagnosed with rickets with pityriasis rubra pilaris. The patient received both medical and physical therapy treatment. The physical therapy rehabilitation program used in this case study significantly improved the patient's functional independence by reducing pain and improving joint mobility, muscle strength, endurance, and gait. After six weeks of rehabilitation, there was an improvement in the ranges of the joint, strength of muscle, gait, and functional independence significantly using physical therapy techniques. This case study shows the value of comprehensive physical therapy in a case of pityriasis rubra pilaris with rickets in a 15-year-old boy.
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23
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Kranyak A, Shuler M. Pityriasis rubra pilaris rapidly cleared with ixekizumab in an HIV-positive patient. JAAD Case Rep 2022; 27:55-57. [PMID: 36035459 PMCID: PMC9399409 DOI: 10.1016/j.jdcr.2022.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Allison Kranyak
- University of South Carolina School of Medicine/Prisma Health Carolina Dermatology, Greenville, South Carolina
| | - Marshall Shuler
- University of South Carolina School of Medicine/Prisma Health Carolina Dermatology, Greenville, South Carolina
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24
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Shakshouk H, Erickson LA, Johnson EF, Lehman JS. Updates and Proposed Diagnostic Approach to Psoriasiform Dermatoses. Adv Anat Pathol 2022; 29:263-274. [PMID: 35180737 DOI: 10.1097/pap.0000000000000333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Psoriasiform dermatoses represent a wide array of skin diseases commonly encountered by clinicians and pathologists. While they may present a diagnostic challenge, thorough observation coupled with proper interpretation of subtle additional clinical or histopathologic features provide clues to the correct diagnosis. In this review, we provide updates on emerging entities and develop a systemic approach to establish the pathologic diagnosis, with emphasis on the importance of clinicopathologic correlation.
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Affiliation(s)
- Hadir Shakshouk
- Departments of Dermatology
- Department of Dermatology, Alexandria University, Alexandria, Egypt
| | - Lori A Erickson
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Emma F Johnson
- Departments of Dermatology
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Julia S Lehman
- Departments of Dermatology
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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25
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Hlaca N, Zagar T, Kastelan M, Peternel S, Brajac I, Dujmovic-Hasanbegovic K, Prpic-Massari L. Pityriasis rubra pilaris following booster dose of mRNA (Pfizer-BioNTech) COVID-19 vaccine. Dermatol Ther 2022; 35:e15791. [PMID: 36029037 PMCID: PMC9538535 DOI: 10.1111/dth.15791] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/27/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Nika Hlaca
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tina Zagar
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Marija Kastelan
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Sandra Peternel
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Ines Brajac
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Katarina Dujmovic-Hasanbegovic
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Larisa Prpic-Massari
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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26
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Okladnikova EV, Kotova KV, Khorzhevskii V, Ruksha TG. Pityriasis rubra pilaris (Devergie's disease) in a COVID-19 patient. VESTNIK DERMATOLOGII I VENEROLOGII 2022. [DOI: 10.25208/vdv1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Pityriasis rubra pilaris (Devergie's disease) is an idiopathic, papulosquamous inflammatory dermatosis characterized by progressive erythrodermia. The etiology of the disease is unknown, and most cases occur sporadically. Viral infections, impaired vitamin A metabolism, medications, autoimmune reactions, and malignancies are most common triggering factors. The diagnosis of Devergie's disease is based on the clinical manifestations of the disease and the results of a skin histological examination. The present paper discusses a clinical case of pityriasis rubra pilaris that occurred in a COVID-19, 40-year-old woman. For the purpose of differential diagnosis of pitiriasis with atopic dermatitis, erythrodermic form of psoriasis, generalized form of urticaria, it is necessary to perform immunohistochemical studies to identify the proliferation of immunocompetent cells. Based on the described clinical case, it seems possible to recommend testing for SARS-CoV-2 if a patient has Devergie's disease against the background of fever and intoxication syndrome.
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27
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Zhao Z, Zhang X, Wang R, Wang Y, Gong L, Li C. Vaccine‐induced erythrodermic psoriasis in a child successfully treated with secukinumab: A case report and brief literature review. Dermatol Ther 2022; 35:e15684. [PMID: 35789520 DOI: 10.1111/dth.15684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/24/2022] [Accepted: 07/03/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Zhenkai Zhao
- Department of Dermatology First Medical Center of Chinese PLA General Hospital Beijing China
| | - Xiaoning Zhang
- Department of Dermatology First Medical Center of Chinese PLA General Hospital Beijing China
| | - Rui Wang
- Department of Dermatology First Medical Center of Chinese PLA General Hospital Beijing China
| | - Youlin Wang
- Department of Dermatology First Medical Center of Chinese PLA General Hospital Beijing China
| | - Lingling Gong
- Department of Dermatology First Medical Center of Chinese PLA General Hospital Beijing China
| | - Chengxin Li
- Department of Dermatology First Medical Center of Chinese PLA General Hospital Beijing China
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28
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Allegue F, Fachal C, Iglesias B, Zulaica A. [Translated article] Facial Discoid Dermatosis: A New Variant of Pityriasis Rubra Pilaris? ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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29
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Gambichler T, Scheel CH, Arafat Y, Kautz O, Boms S. Erythrodermic pityriasis rubra pilaris after SASRS-CoV-2 vaccination with concomitant COVID-19 infection. J Eur Acad Dermatol Venereol 2022; 36:e675-e676. [PMID: 35536694 PMCID: PMC9347623 DOI: 10.1111/jdv.18214] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Y Arafat
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - O Kautz
- NordWestHisto, Westerstede, Germany
| | - S Boms
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
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30
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DeBiasio C, Cyr J, Ayroud Y, Glassman SJ. A case of classic adult pityriasis rubra pilaris successfully treated with a combination of acitretin and ustekinumab: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221093453. [PMID: 35465019 PMCID: PMC9021576 DOI: 10.1177/2050313x221093453] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Classic adult pityriasis rubra pilaris is a severe papulosquamous disease that tends to resolve in 3-5 years but can have a devastating impact on patients while active. It shares features with psoriasis, but treatment remains largely empiric, based on case reports and series. The condition is often refractory to treatment, especially initially, with topical corticosteroids and oral acitretin the more commonly employed agents. Relatively high doses of acitretin are needed for adequate response, and adverse events often limit adherence. Given the similarity to psoriasis, biologic agents approved for psoriasis have been used with good effect in classic adult pityriasis rubra pilaris and show better tolerance than other agents. In this report, we describe the successful use of a combination of acitretin and ustekinumab in a case of classic adult pityriasis rubra pilaris.
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Affiliation(s)
- Celina DeBiasio
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Janelle Cyr
- Division of Dermatology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Yasmine Ayroud
- Department of Anatomical Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Steven J Glassman
- Division of Dermatology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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31
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Ajebo EM, Howard JD, Anand D, Davis LS. Pityriasis Rubra Pilaris Potentially Triggered by mRNA-1273 COVID Vaccine. JAAD Case Rep 2022; 23:114-116. [PMID: 35465138 PMCID: PMC9013576 DOI: 10.1016/j.jdcr.2022.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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32
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Banjar TA, Abdulwahab RA, Al Hawsawi KA. Confluent and Reticulated Papillomatosis of Gougerot and Carteaud: A Case Report and Review of the Literature. Cureus 2022; 14:e24557. [PMID: 35651451 PMCID: PMC9138193 DOI: 10.7759/cureus.24557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Confluent and reticulated papillomatosis (CARP) of Gougerot and Carteaud is a rare chronic disease with exacerbation and remissions typically affecting young people. Classic clinical characteristics include asymptomatic scaly hyperpigmented macules, patches, and papules in the trunk's confluent and reticular pattern. A 12-year-old girl, otherwise healthy, presented with itchy, persistent skin lesions all over her body for one year. Skin examination revealed generalized scaly brownish patches, thin papules, and plaques all over her body, including her face, neck, middle of the chest, abdomen, back, upper extremities, elbows, lower extremities, and knees. Wood's lamp examination of her skin lesions was unrevealing. Skin biopsy showed papillomatosis, hyperkeratosis, acanthosis, and hypergranulosis. The dermis showed perivascular inflammatory cellular infiltrate. Based on the above clinicopathological findings, the patient was diagnosed with CARP. In our case, a generalized form was reported. CARP is diagnosed based on clinical and histopathological features. Oral antibiotics are the cornerstone of treatment. Our patient responded well to oral minocycline 85 mg one tablet daily, tacrolimus 0.1% ointment twice daily, and selenium sulfide shampoo twice weekly for two months. The classic clinical characteristics of CARP include asymptomatic scaly hyperpigmented macules, patches, and papules in a confluent and reticular pattern on the trunk. A generalized form, as in our case, has been reported. CARP is diagnosed based on clinical and histopathological features. Oral antibiotics are the cornerstone of treatment.
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33
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Criado P, Ianhez M, Rocha P, Miot H. Pityriasis rubra pilaris (type I) following ChAdOx1 COVID‐19 vaccine: report of two cases with successful treatment with oral isotretinoin. J Eur Acad Dermatol Venereol 2022; 36:e508-e510. [PMID: 35278239 PMCID: PMC9114897 DOI: 10.1111/jdv.18055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/02/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- P.R. Criado
- Centro Universitário Faculdade de Medicina do ABC and Alergoskin Alergia e Dermatologia Santo André SP Brazil
| | - M. Ianhez
- Universidade Federal de Goiás (UFG) and Cório Clínica de Dermatologia Goiânia GO Brazil
- Hospital de Doenças Tropicais Goiânia GO Brazil
| | - P.S. Rocha
- Hospital de Doenças Tropicais Goiânia GO Brazil
| | - H.A. Miot
- UNESP Medical School Botucatu SP Brazil
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34
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Abstract
Vitamin and mineral supplement consumption is widespread. They are taken for a variety of conditions, including dermatologic disorders. Although consumers often assume these supplements are safe, excessive consumption of supplements may have deleterious effects. Such vitamin supplements include vitamin A, niacin, biotin, vitamin D, and vitamin E, and specific mineral supplements include zinc, copper, and iron. These supplements may have a number of potential adverse effects.
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Affiliation(s)
- Freidrich Anselmo
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Marcia S Driscoll
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
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35
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Shao S, Chen J, Swindell WR, Tsoi LC, Xing X, Ma F, Uppala R, Sarkar MK, Plazyo O, Billi AC, Wasikowski R, Smith KM, Honore P, Scott VE, Maverakis E, Kahlenberg JM, Wang G, Ward NL, Harms PW, Gudjonsson JE. Phospholipase A2 enzymes represent a shared pathogenic pathway in psoriasis and pityriasis rubra pilaris. JCI Insight 2021; 6:e151911. [PMID: 34491907 PMCID: PMC8564909 DOI: 10.1172/jci.insight.151911] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/03/2021] [Indexed: 02/02/2023] Open
Abstract
Altered epidermal differentiation along with increased keratinocyte proliferation is a characteristic feature of psoriasis and pityriasis rubra pilaris (PRP). However, despite this large degree of overlapping clinical and histologic features, the molecular signatures these skin disorders share are unknown. Using global transcriptomic profiling, we demonstrate that plaque psoriasis and PRP skin lesions have high overlap, with all differentially expressed genes in PRP relative to normal skin having complete overlap with those in psoriasis. The major common pathway shared between psoriasis and PRP involves the phospholipases PLA2G2F, PLA2G4D, and PLA2G4E, which were found to be primarily expressed in the epidermis. Gene silencing each of the 3 PLA2s led to reduction in immune responses and epidermal thickness both in vitro and in vivo in a mouse model of psoriasis, establishing their proinflammatory roles. Lipidomic analyses demonstrated that PLA2s affect mobilization of a phospholipid-eicosanoid pool, which is altered in psoriatic lesions and functions to promote immune responses in keratinocytes. Taken together, our results highlight the important role of PLA2s as regulators of epidermal barrier homeostasis and inflammation, identify PLA2s as a shared pathogenic mechanism between PRP and psoriasis, and as potential therapeutic targets for both diseases.
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Affiliation(s)
- Shuai Shao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China.,Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jiaoling Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - William R Swindell
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Internal Medicine, the Jewish Hospital, Cincinnati, Ohio, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Feiyang Ma
- Department of Dermatology, Department of Medicine, UCLA, Los Angeles, California, USA
| | - Ranjitha Uppala
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Olesya Plazyo
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rachael Wasikowski
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Prisca Honore
- AbbVie Dermatology Discovery, North Chicago, Illinois, USA
| | | | - Emanual Maverakis
- Department of Dermatology, UC Davis School of Medicine, Sacramento, California, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi, China
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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36
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Sánchez-Cárdenas CD, Vega-Memije ME, Flores-Gavilán P, Romero M, Arenas R, Sánchez RL. Disseminated and recurrent infundibulofolliculitis in children in Mexico. Pediatr Dermatol 2021; 38:1233-1236. [PMID: 34515382 DOI: 10.1111/pde.14803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Disseminated and recurrent infundibulofolliculitis is an uncommon non-infectious skin eruption characterized by recurrent, sometimes pruritic, follicular papules commonly seen on the trunk and proximal extremities. We describe the clinical, dermoscopic, and histopathologic characteristics of disseminated and recurrent infundibulofolliculitis in three young pediatric patients from the tropical regions of Mexico, Guerrero, and Chiapas.
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Affiliation(s)
- Carlos Daniel Sánchez-Cárdenas
- Departamento de Dermatología, Intituto Mexicano del Seguro Social, Centro Médico Nacional "La Raza", Ciudad de Mexico, Mexico
| | - María Elisa Vega-Memije
- Sección de Dermatopatología, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico
| | - Paola Flores-Gavilán
- Sección de Dermatopatología, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico
| | - Marina Romero
- Sección de Micología, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico
| | - Roberto Arenas
- Sección de Micología, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico
| | - Ramon L Sánchez
- Dermopath.Laboratories LLC, Galveston Dermatology, PA, Galveston, TX, USA
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Sahni MK, Roy K, Asati DP, Khurana U. An old entity, a new trigger: Post COVID-19 vaccine pityriasis rubra pilaris. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2021; 32:261-264. [PMID: 34420983 DOI: 10.3233/jrs-210048] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pityriasis rubra pilaris (PRP) is a rare, acquired, chronic papulosquamous dermatosis which can occur in all ages. PRP can be associated with infection, autoimmunity, drugs and malignancies, and can be idiopathic. OBJECTIVE PRP following vaccination has been rarely described in the literature. To the best of our knowledge, we report the first case of PRP two weeks following COVID-19 vaccination (Covishield). CASE REPORT A 72-year-old male presented to the outpatient dermatology department at All India Institute of Medical Sciences - Bhopal with minimally pruritic superficial plaques since one week. The patient was vaccinated against COVID-19 with Covishield two weeks earlier. The lesions developed as erythematous scaly follicular papules and plaques over axilla that rapidly spread to the trunk in the following weeks and involved palms and soles as well as thickening and fissuring. The clinical features suggested PRP. The histopathology showed epidermal acanthosis with hypergranulosis alternating with parakeratosis and orthokeratosis with broad rete ridges with follicular plugging. The patient had started taking topical corticosteroids and emollients, which proved effective. There was no recurrence after receiving a second dose on follow-up. CONCLUSION In patients presenting with new onset PRP in this COVID-19 era, the possibility of vaccine as a trigger should be taken into consideration, and further dosing should be carefully monitored in view of possible recurrence.
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Affiliation(s)
| | - Kanika Roy
- All India Institute of Medical Sciences - Bhopal, Bhopal, India
| | - Dinesh Prasad Asati
- Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences - Bhopal, Bhopal, India
| | - Ujjawal Khurana
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences - Bhopal, Bhopal, India
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38
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SnapshotDx Quiz: August 2021. J Invest Dermatol 2021. [PMID: 34303470 DOI: 10.1016/j.jid.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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39
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Allegue F, Fachal C, Iglesias B, Zulaica A. Facial Discoid Dermatosis: A New Variant of Pityriasis Rubra Pilaris? ACTAS DERMO-SIFILIOGRAFICAS 2021; 113:728-731. [PMID: 33992621 DOI: 10.1016/j.ad.2021.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/20/2020] [Accepted: 01/11/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- F Allegue
- Servicio de Dermatología. Hospital do Meixoeiro, EOXI, Vigo, Spain.
| | - C Fachal
- Servicio de anatomía Patológica. Hospital Álvaro Cunqueiro, EOXI, Vigo, Spain
| | - B Iglesias
- Servicio de anatomía Patológica. Hospital Álvaro Cunqueiro, EOXI, Vigo, Spain
| | - A Zulaica
- Servicio de Dermatología. Hospital do Meixoeiro, EOXI, Vigo, Spain
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40
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Lamberg O, Cao S, Sabater-Geib S, Lowe L, Elder J. A case of recurrent and paraneoplastic pityriasis rubra pilaris. JAAD Case Rep 2021; 12:74-76. [PMID: 34041337 PMCID: PMC8141418 DOI: 10.1016/j.jdcr.2021.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Olivia Lamberg
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Severine Cao
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan
| | | | - Lori Lowe
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan.,Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan
| | - James Elder
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan.,Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
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41
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Kettering C, Khosravi H, Ortiz C, English JC. Drug survival of systemic and biologic monotherapy treatments for pityriasis rubra pilaris: A retrospective observational study. J Am Acad Dermatol 2021; 86:1142-1143. [PMID: 33894320 DOI: 10.1016/j.jaad.2021.04.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/29/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Affiliation(s)
| | - Hasan Khosravi
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
| | - Camila Ortiz
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Joseph C English
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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42
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Ghatnekar S, Shah N, Min MS, Mazori DR, LaChance AH, Vleugels RA, Nambudiri VE. Clinical features and eosinophilia in pityriasis rubra pilaris: A multicenter cohort. J Am Acad Dermatol 2021; 86:907-909. [PMID: 33771592 DOI: 10.1016/j.jaad.2021.03.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Shilpa Ghatnekar
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts
| | - Nidhi Shah
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Michelle S Min
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Daniel R Mazori
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Avery H LaChance
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Ruth Ann Vleugels
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.
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43
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Kwak RB, Hafeez F, Lian C, Nambudiri VE. Paraneoplastic pityriasis rubra pilaris heralding onset of new hematologic malignancy. Am J Hematol 2021; 96:272-274. [PMID: 32501564 DOI: 10.1002/ajh.25897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/25/2020] [Accepted: 05/28/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Ruby B. Kwak
- Harvard Medical School Boston Massachusetts USA
- Department of Dermatology Brigham and Women's Hospital Boston Massachusetts USA
| | - Farhaan Hafeez
- Department of Pathology Brigham and Women's Hospital Boston Massachusetts USA
| | - Christine Lian
- Department of Pathology Brigham and Women's Hospital Boston Massachusetts USA
| | - Vinod E. Nambudiri
- Harvard Medical School Boston Massachusetts USA
- Department of Dermatology Brigham and Women's Hospital Boston Massachusetts USA
- Department of Cutaneous Oncology Dana Farber Cancer Institute Boston Massachusetts USA
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44
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Mahlangeni GM, Tod BM, Jordaan HF, Schneider JW. Clinicopathological Features of Seborrheic-Like Dermatitis in HIV-Infected Adults: A Single Institutional Descriptive Cross-Sectional Study. Am J Dermatopathol 2021; 43:27-34. [PMID: 32379092 DOI: 10.1097/dad.0000000000001670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Atypical and severe clinical presentations of seborrheic-like dermatitis (SLD) are associated with HIV infection, correlating with advanced disease or low CD4 counts. Previous studies documented histological findings characteristic of seborrheic dermatitis in HIV-positive patients. OBJECTIVE To expand current knowledge of the clinicopathological characteristics of SLD in South African HIV-seropositive individuals. METHODS This prospective study included HIV-seropositive adult patients presenting with SLD to a dermatology clinic from March 2017 to April 2018. A dermatologist established the diagnosis of SLD and the severity of the disease. Detail about antiretroviral therapy (ART), the latest CD4 count, and the viral load was retrieved from the patients' clinical records. Histopathological assessment of the patients' skin biopsies was recorded using standardized data sheets and semiquantifiable grades. RESULTS This study included 13 women and 17 men. Fifty percent of patients showed severe or very severe SLD. Six (20.0%) patients presented with erythroderma. Statistical analysis did not show a significant correlation between severity of disease and CD4 count, viral load, or ART, respectively. This study confirmed that the presence of confluent parakeratosis, necrotic keratinocytes, plasma cells, neutrophils with leukocytoclasia, and leukoexocytosis are histopathological clues to SLD occurring in HIV-seropositive patients. CONCLUSION SLD in HIV patients may present with varying clinical severity, including erythroderma. The association between the prevalence and severity of SLD with CD4 count, viral load, and ART requires further studies with larger patient populations. The presence of specific histopathological features in a skin biopsy of SLD is a clue to the diagnosis of HIV.
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Affiliation(s)
- Gcina M Mahlangeni
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa; and
| | - Bianca M Tod
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa; and
| | - Hendry Francois Jordaan
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa; and
| | - Johann W Schneider
- Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Academic Hospital, Cape Town, South Africa
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45
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Gisondi P, Bellinato F, Girolomoni G. Topographic Differential Diagnosis of Chronic Plaque Psoriasis: Challenges and Tricks. J Clin Med 2020; 9:E3594. [PMID: 33171581 PMCID: PMC7695211 DOI: 10.3390/jcm9113594] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Psoriasis is an inflammatory skin disease presenting with erythematous and desquamative plaques with sharply demarcated margins, usually localized on extensor surface areas. OBJECTIVE To describe the common differential diagnosis of plaque psoriasis classified according to its topography in the scalp, trunk, extremities, folds (i.e., inverse), genital, palmoplantar, nail, and erythrodermic psoriasis. METHODS A narrative review based on an electronic database was performed including reviews and original articles published until 1 September 2020, assessing the clinical presentations and differential diagnosis for psoriasis. RESULTS Several differential diagnoses could be considered with other inflammatory, infectious, and/or neoplastic disorders. Topographical differential diagnosis may include seborrheic dermatitis, tinea capitis, lichen planopilaris in the scalp; lupus erythematosus, dermatomyositis, cutaneous T-cell lymphomas, atopic dermatitis, syphilis, tinea corporis, pityriasis rubra pilaris in the trunk and arms; infectious intertrigo in the inguinal and intergluteal folds and eczema and palmoplantar keratoderma in the palms and soles. CONCLUSIONS Diagnosis of psoriasis is usually straightforward but may at times be difficult and challenging. Skin cultures for dermatophytes and/or skin biopsy for histological examination could be required for diagnostic confirmation of plaque psoriasis.
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Affiliation(s)
- Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37129 Verona, Italy; (F.B.); (G.G.)
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46
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Amat-Samaranch V, Cubiró X, Tubau C, Garcia-Melendo C, Puig L. Response of pityriasis rubra pilaris to brodalumab after primary failure to ustekinumab. Int J Dermatol 2020; 60:e112-e114. [PMID: 33128453 DOI: 10.1111/ijd.15219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Victoria Amat-Samaranch
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Cubiró
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carla Tubau
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Garcia-Melendo
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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47
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Liang JY, Ye RX, Tian X, Zhang SQ, Zhang XB. Secukinumab monotherapy successfully treated severe refractory type V (atypical juvenile) pityriasis rubra pilaris: A case report and literature review. Dermatol Ther 2020; 33:e14097. [PMID: 32725719 DOI: 10.1111/dth.14097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 11/29/2022]
Abstract
Pityriasis rubra pilaris (PRP) is a rare heterogeneous group of papulosquamous inflammatory disorders with unknown etiology. PRP is often resistant to many conventional therapies which has made more challenging on treatment. More recently, several studies have shown encouraging clinical results of secukinumab in the treatment of PRP in adult, but no studies have explored its effects in children. We herein report a 7-year-old boy with severe type V PRP responded rapidly to secukinumab monotherapy (150 mg once weekly) when conventional therapies have failed. The patient showed rapid and dramatic improvement of erythema, palmoplantar hyperkeratosis, scaling, and itching within only 5 weeks, with no adverse effects. Secukinumab could be considered as a treatment option for refractory PRP in children, as recently reported in adult.
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Affiliation(s)
- Jing-Yao Liang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
| | - Rui-Xian Ye
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
| | - Xin Tian
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
| | - San-Quan Zhang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
| | - Xi-Bao Zhang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
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48
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Camela E, Miano C, Di Caterino P, Lo Presti M, De Fata Salvatores G, Fabbrocini G, Megna M. Erythrodermic pityriasis rubra pilaris treatment: Two case reports and literature review. Dermatol Ther 2020; 33:e14223. [PMID: 32820849 DOI: 10.1111/dth.14223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/07/2020] [Accepted: 08/17/2020] [Indexed: 01/16/2023]
Abstract
Pityriasis rubra pilaris (PRP) is a rare inflammatory dermatosis characterized by hyperkeratotic follicular papules and erythematous-desquamative plaques that tend to progressively evolve into erythroderma. Treatment is challenging given that international guidelines are not available and large-scale trials do not exist. Traditionally, many topical and systemic drugs had been used as consolidated agents; recently, biologicals are gaining increasing importance, promisingly dominating the therapeutic scenario ahead. Herein, we present a case series showing the "past" and the "future" therapeutic approaches to erythrodermic PRP, one case treated with acitretin and nb-UVB phototherapy combination, while the other with ustekinumab, performing also a throughout literature review.
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Affiliation(s)
- Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Chiara Miano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Paola Di Caterino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maurizio Lo Presti
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gaia De Fata Salvatores
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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49
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Chin LD, Parvinnejad N, Haber RM. Pityriasis in dermatology: an updated review. Int J Dermatol 2020; 60:141-158. [PMID: 32783190 DOI: 10.1111/ijd.15097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/30/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022]
Abstract
Dermatology has a very distinctive lexicon. The term pityriasis refers to several dermatologic conditions which all feature scaling of the skin. According to the Merriam-Webster dictionary, the term pityriasis was first used in print in 1684. Although the diseases beginning with the name pityriasis are of diverse causation, they do represent important dermatologic diseases, with some common and others quite rare. It is important for dermatologists to be aware and updated on all pityriasis conditions in dermatology.
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Affiliation(s)
- Laura D Chin
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nikoo Parvinnejad
- Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Richard M Haber
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
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50
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Sander M, Sander M. Acral pityriasis rubra pilaris. CMAJ 2020; 192:E118. [PMID: 32015081 DOI: 10.1503/cmaj.190961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Michael Sander
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Megan Sander
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.
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