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Pityriasis rubra pilaris (PRP) is a papulosquamous disease that is psoriasis-like in many of its manifestations. However, unlike psoriasis, the lifespan of this disease process is often a finite 1 to 3 years. Nevertheless, the active phase of the disease is frequently severe and debilitating. There are no randomized, controlled trials to direct therapy of PRP, but in many patients, the use of methotrexate or acitretin alone or in combination has been reported to be helpful. Ultraviolet UV) light therapy also has reported benefit, but many patients worsen with UV therapy. Other alternatives include tumor necrosis factor antagonists and ustekinumab.
These authors present the case of an adult patient with PRP refractory to acitretin, methotrexa…