Pityriasis rubra pilaris

QUESTION 5

A 54-year-old male presents to the dermatology office as a referral for the rapid onset of erythroderma. The changes initially presented on his head and neck. He was treated for seborrheic dermatitis with ketoconazole 2% shampoo. Despite treatment, the rash spread caudally over the next few weeks, with 90% BSA involvement. He feels that he is worse with exposure to UV light. On physical examination, there are confluent salmon-coloured thin plaques with islands of sparing. There is also follicular hyperkeratosis giving the skin a nutmeg grater appearance (5a). The palms and soles have an orange-red waxy keratoderma (5b); however, the nails appear normal without pits, onycholysis or oil drops.

Only gold members can continue reading. Log In or Register to continue