Focal Acantholytic Dyskeratosis Occurring in Pityriasis Rubra Pilaris

The Incidence of Acantholysis in Pityriasis Rubra Pilaris—Histopathological Study Using Multiple-Step Sections and Clinicopathologic Correlations

“…In addition, there were reports of selected or collected PRP cases with acantholysis adding up to 27 of 47 (mean: 57%) biopsies with acantholysis. 2,[5][6][7][8][9][10][11][12][13]15 Acantholysis was not present in the initial sections of any of our PRP biopsies, but in 6.5%-46% (mean: 31%) of the step sections of 5 biopsies, suggesting that acantholysis may not be a constant histopathological characteristic of PRP, and it may be present in only the minority of the sections.…”

“…Proteolytic enzymes were speculated as causative agents, 2,11 in accordance with the nonspecific pattern of acantholysis seen in our cases and in previous ones. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] Understanding the mechanism of acantholysis may shed more light on the molecular basis and the pathogenesis of PRP.…”

Pityriasis rubra pilaris

“…4). 59 , 89 , 94–98 These nonspecific histologic findings had been previously recognized in other conditions, such a Darier–White disease, Grover's disease, Hailey–Hailey disease, and pemphigus, but not PRP. Magro and Crowson 89 found acantholytic dyskeratosis in 23 of 32 biopsies from patients with PRP, and in zero of 23 biopsies in a control group with psoriasis, indicating that it is an important feature for distinguishing between the two diseases.…”

(Juvenile) Pityriasis rubra pilaris

“…Plugging of follicular infundibula by cornified cells is seen only in biopsy specimens that come from lesions that are clinically indubitably follicular. 78,[83][84][85] Magro and Crowson 78 recorded acantholytic dyskeratosis in 23 of 32 biopsies from PRP patients, whereas it was absent in 23 psoriatic controls. They may indicate an acute and /or infected episode.…”