SHM Converge Scientific Abstract ePoster Gallery-A Spontaneous Case and Treatment of Pityriasis Rubra Pilaris

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A 72-year-old man with diabetes developed a progressively worsening, widespread rash over three months, beginning with peeling of the forehead and spreading to the hands and lower extremities. He had already been treated with prednisone, topical steroids, and doxycycline without improvement. Shortly before symptom onset, his antihypertensive medication was changed from an ACE inhibitor to losartan; losartan was held after admission because of concern it may have contributed to the eruption.<br /><br />Skin biopsy confirmed pityriasis rubra pilaris (PRP). During hospitalization, he was treated with prednisone, acitretin, topical triamcinolone and hydrocortisone, and ixekizumab (Taltz), a biologic that targets IL-17. He experienced marked improvement in skin inflammation, along with better mood and mental well-being, which had worsened as his disease progressed. He was discharged on daily acitretin and Taltz injections every other week.<br /><br />The case highlights PRP as a rare, severe inflammatory skin disorder that can be extensive and distressing. It also raises the possibility of a medication trigger, since onset followed a switch to losartan, although a definite causal link was not established. The patient’s response suggests that combined systemic therapy, including acitretin and ixekizumab, may be effective in severe PRP.

Asset Subtitle

Anthony Ko

Meta Tag

Author List Anthony Ko, Kashif Khan

Category Clinical Vignettes

Concept Pityriasis Rubra Pilaris

Concept Erythematous Scaling Rash

Concept Skin Biopsy

Concept Cephalocaudal Spread

Concept Histopathology

Distinguished Non-Finalist

Presenter Organization The Ohio State University College of Medicine

Presenting Author Anthony Ko

Track Adult

Keywords

pityriasis rubra pilaris

PRP

losartan

ixekizumab

acitretin

biologic therapy

skin biopsy

rash

inflammatory skin disorder

diabetes

Pityriasis Rubra Pilaris

Erythematous Scaling Rash

Skin Biopsy

Cephalocaudal Spread

Histopathology