Almoqati Mehad, Almasoudi Lama, Alfaqih Zainab, Fageeh Sarah M, Al Hawsawi Khalid
College of Medicine, Taif University, Taif, SAU.
Faculty of Medicine, Umm Al-Qura University, Makkah, SAU.
Cureus. 2024 Aug 17;16(8):e67077. doi: 10.7759/cureus.67077. eCollection 2024 Aug.
Pityriasis rubra pilaris (PRP) is a rare, chronic, inflammatory papulosquamous skin disease. Here, we report a case of a 43-year-old female with a known history of atopic dermatitis, bronchiectasis, and goiter who presented with a six-month history of persistent itchy skin lesions on her extremities. A skin examination revealed multiple diffuse, well-defined, fine, scaly erythematous patches with areas of spared skin over all four extremities, along with palmoplantar keratoderma. The trunk was spared. The differential diagnosis included atopic eczema, pityriasis rubra pilaris, dermatomyositis, mycosis fungoides, parapsoriasis, psoriasis, and drug-induced eczematous dermatitis. A skin biopsy revealed hyperkeratosis, acanthosis, spongiosis, follicular plugging, and mild perivascular lymphohistiocytic cellular infiltrates in the dermis. Based on the clinicopathological findings, the patient was diagnosed with atypical adult pityriasis rubra pilaris (PRP) (type II). She was started on narrowband UVB phototherapy (NBUVB). Two months after starting NBUVB treatment, all the skin lesions had cleared. She was put under periodic follow-up, and the lesions have remained clear for two years up to the time of this publication.
红皮病型毛发红糠疹（PRP）是一种罕见的慢性炎症性丘疹鳞屑性皮肤病。在此，我们报告一例43岁女性病例，该患者有特应性皮炎、支气管扩张和甲状腺肿病史，四肢出现持续瘙痒性皮肤病变6个月。皮肤检查发现四肢均有多个弥漫性、边界清晰、细小、鳞屑性红斑斑块，有皮肤 spared 区域，同时伴有掌跖角化病。躯干未受累。鉴别诊断包括特应性湿疹、红皮病型毛发红糠疹、皮肌炎、蕈样肉芽肿、副银屑病、银屑病和药物性湿疹性皮炎。皮肤活检显示角化过度、棘层肥厚、海绵形成、毛囊堵塞以及真皮轻度血管周围淋巴细胞组织细胞浸润。根据临床病理结果，该患者被诊断为非典型成人红皮病型毛发红糠疹（PRP）（II型）。她开始接受窄谱中波紫外线光疗（NBUVB）。开始NBUVB治疗两个月后，所有皮肤病变均已清除。她接受定期随访，截至本文发表时，病变已持续两年未复发。
