Diagnosis and Treatment of Pityriasis Rubra Pilaris

Abstract The article deals with clinical diagnosis and treatment of pityriasis rubra pilaris (PRP). The authors analyze the diagnostic errors, present literature review, and their own observations. The clinical study included 23 patients with pityriasis rubra pilaris: 18 women and 5 men, average age of 54 ± 7.2. The clinical diagnosis of all examined patients was subsequently confirmed by histological analysis of the skin. The primary clinical diagnosis was psoriasis in 15 (65.2%) patients, 6 (26%) patients received treatment for toxic exanthema, and only 2 (8.8%) patients were presumptively diagnosed with pityriasis rubra pilaris. In conclusion, pityriasis rubra pilaris was initially misdiagnosed in 91.2% of patients. Considering the great number of diagnostic errors, we analyzed the main diagnostic and differential diagnostic features of PRP. The most effective of all synthetic retinoids in PRP treatment is acitretin. Although symptomatic improvement in PRP occurs within a month, substantial improvement, even clearing is possible within 4 - 6 months.