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Pityriasis rubra pilaris (PRP) is an inflammatory dermatologic disorder of unknown cause characterized by hyperkeratotic follicular papules combining into salmon-colored scaling plaques, palmoplantar hyperkeratosis, and sharply demarcated islands of spared skin.1 We report a case of refractory PRP treated with the immune modulator apremilast.
A white man in his 70s presented with an 8-month history of scaling, pink, pruritic papules, originating on his back (Figure, A), which coalesced to encompass nearly his entire body surface. There was extensive erythema with scaling and waxy, hyperkeratotic scaling of the palms and soles.
Krase IZ, Cavanaugh K, Curiel-Lewandrowski C. Treatment of Refractory Pityriasis Rubra Pilaris With Novel Phosphodiesterase 4 (PDE4) Inhibitor Apremilast. JAMA Dermatol. 2016;152(3):348-350. doi:10.1001/jamadermatol.2015.3405