Pityriasis rubra pilaris secondary to viral infection

Introduction:
Pityriasis rubra pilaris is a rare, chronic dermatosis presenting with erythema and papular eruptions as well as characteristic perifollicular hyperkeratosis and ‘islands of sparing’ (normal appearing skin). In the literature, there are reports of cases where symptoms of infection preceded the onset of pityriasis rubra pilaris.

Objective:
Presentation of the case of a 67-year-old patient with type I pityriasis rubra pilaris to highlight the possible association between pityriasis rubra pilaris with infectious agents.

Case report:
A 67-year-old patient was referred to hospital because of rapidly progressive erythematous papular skin rash preceded by symptoms of an upper respiratory tract infection. On physical examination, attention was drawn to perifollicular papules covered with cap-like scales as well as confluent erythema and features of hyperkeratosis on the hands and feet. Based on the clinical presentation and histopathological findings, type I pityriasis rubra pilaris was diagnosed and treatment with acitretin was initiated.

Conclusions:
Infectious agents have the potential to be a trigger for pityriasis rubra pilaris. Acitretin continues to demonstrate efficacy in the treatment of pityriasis rubra pilaris.