Pityriasis rubra pilaris and HIV infection: a part of the spectrum of HIV-associated fnllicular syndrome

Sánchez‐Regaña, M.; Fuentes, Cristina; Creus, L.; Salleras, M.; Umbert, Pablo

doi:10.1111/j.1365-2133.1995.tb02769.x

Cited by 18 publications

(19 citation statements)

References 13 publications

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“…Since the first description in 1991, 2 reports of a number of similar cases have shown that, while rare, this triad of features comprises a recognized entity in HIV infected patients. Seven cases, including our own, have shown simultaneously occurring acneiform or hidradenitis‐like lesions and filiform keratotic spines, with histopathological features of PRP 2–6 (Table 1) Other reports describe the development of two features of this triad in HIV positive men 7–9 . While more typical PRP has also been reported in three other HIV infected patients, one a child, 10–12 they lacked the follicular spines and acneiform lesions seen in this ‘follicular syndrome’.…”

Section: Reportmentioning

confidence: 57%

“…Seven cases, including our own, have shown simultaneously occurring acneiform or hidradenitis-like lesions and filiform keratotic spines, with histopathological features of PRP [2][3][4][5][6] (Table 1) Other reports describe the development of two features of this triad in HIV positive men. [7][8][9] While more typical PRP has also been reported in three other HIV infected patients, one a child, [10][11][12] they lacked the follicular spines and acneiform lesions seen in this 'follicular syndrome'. All reported cases developed skin signs after, or at the time of, diagnosis of HIV infection, and none had a prior history of PRP.…”

Section: Reportmentioning

confidence: 73%

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Spontaneous clinical improvement in HIV-associated follicular syndrome

et al. 2004

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Since 1991 infrequent reports have described a distinctive triad of nodulocystic acne, striking follicular spines and an eruption resembling pityriasis rubra pilaris (PRP) in HIV-positive patients. It has been suggested that this may represent a subtype of PRP, or alternatively that it should be viewed as a unique HIV-associated follicular occlusion triad. Clinical manifestations may be severe, and in several cases have been ultimately fatal, with death occurring due to complications of cutaneous sepsis. We describe a case demonstrating severe conglobate acne, follicular keratotic spines and histologically confirmed PRP in association with HIV infection. Clinical features and treatment modalities of previously reported cases are reviewed. Despite refusing all topical and systemic treatment our patient showed spontaneous remission of skin signs after 2 years.

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Section: Reportmentioning

confidence: 57%

Section: Reportmentioning

confidence: 73%

Spontaneous clinical improvement in HIV-associated follicular syndrome

et al. 2004

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“…The relation of HIV infection and onset of PRP may be coincidental or it may be correlated. That only 13 patients 2–10 (Table I) including the index case have been reported in the English literature to date gives credence to a coincidental etiology; however, low prevalence of PRP in general may be the cause of such rarity.…”

Section: Review Of Cases Of Prp In Association With Hiv Infection Repmentioning

confidence: 97%

“…A new subtype, human immunodeficiency virus (HIV)‐associated PRP (type 6 PRP), was added in 1995 2 . During the past 15 years, 12 cases 2–10 of type 6 PRP have been reported from various parts of the world.…”

Section: Review Of Cases Of Prp In Association With Hiv Infection Repmentioning

confidence: 99%

Pityriasis Rubra Pilaris in a HIV‐Positive Patient (Type 6 PRP)

Dogra

Narang

et al. 2008

Skinmed

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A 45-year-old previously healthy man presented with minimally itchy spiny papular lesions of 3 years' duration and discharging nodular cystic lesions for the past 2 years. Initially, lesions appeared on his ears, followed by the gradual appearance of similar lesions over his face, back, and extremities. The lesions were not associated with photosensitivity. Over the years, the patient continued to have similar lesions without any significant response to various topical medications and oral antibiotics. There was no history of fever or any other systemic complaints and the patient denied any other significant medical problems in the past. Cutaneous examination revealed multiple, grouped, spiny papular lesions coalescing to form plaques at places over the ears, extremities, and trunk (Figure 1). Elongated, horny, follicular spires were noted on the top of the papular lesions. Multiple discharging nodular lesions with crusting were seen predominantly over the chest, abdomen, and back (Figure 2), and closed comedonal lesions were noted on the face and trunk. Multiple orange-brown scaly plaques were seen over the extensor aspect of the patient's thighs (Figure 1, inset). A few nails showed wedge-shaped thickening without subungual hyperkeratosis or other nail changes. Palms, soles, and oral mucosa were normal. Considering the atypical cutaneous findings, the clinical possibility of pityriasis rubra pilaris (human immunodeficiency virus [HIV]-associated type 6 PRP) was considered. Hematoxylin and eosin stain of skin biopsy specimens taken from the spiny papular and plaque lesions revealed marked hyperkeratosis with alternating orthokeratosis and parakeratosis with follicular keratotic plugging (Figure 3; Figure 3, inset). Irregular broad acanthosis was also detected in the epidermis. Dermis showed moderate perivascular lymphomononuclear inflammatory infiltrate. Thus, the skin biopsy was consistent with PRP. HIV serology by enzyme-linked immunosorbent assay (ELISA) with 3 different kits was found to be positive for HIV-1. The patient denied any risk factors associated with acquiring HIV infection, and laboratory values for complete blood cell count, routine serum biochemical profile, and lipid profile were normal. The patient was prescribed oral isotretinoin and asked to come for follow-up for CD4 T-cell count, but did not return.

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“…2 A sixth group associated with human immunodeficiency virus infection has been suggested. 3 The prognosis of acute adult PRP (type 1 PRP) was estimated approximately by a study of cases seen at St John's Skin Hospital. In this study, 46 of 102 patients had type 1 disease, and 80% cleared, in an average of 3 years.…”

Section: Reportmentioning

confidence: 99%

Pityriasis rubra pilaris type 1 spontaneously resolving after 20 years

Abbott

Griffiths

2009

Clinical and Experimental Dermatology

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Pityriasis rubra pilaris (PRP) is an uncommon, idiopathic, papulosquamous eruption. We report a longitudinal study of a patient with PRP type 1 who was treated with retinoid therapy for 9 years and whose symptoms resolved spontaneously after 20 years. There are no data in the literature on the disease course of PRP type 1 persisting beyond the usual 3 years. This case highlights both the extreme chronicity of PRP and the possibility of remission after many years of active disease.

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Pityriasis rubra pilaris and HIV infection: a part of the spectrum of HIV-associated fnllicular syndrome

Cited by 18 publications

References 13 publications

Spontaneous clinical improvement in HIV-associated follicular syndrome

Spontaneous clinical improvement in HIV-associated follicular syndrome

Pityriasis Rubra Pilaris in a HIV‐Positive Patient (Type 6 PRP)

Pityriasis rubra pilaris type 1 spontaneously resolving after 20 years

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