Pityriasis rubra pilaris in Association with Polyarthritis

Nakafusa, Junji; Misago, Noriyuki; Narisawa, Yutaka

doi:10.1159/000065842

Cited by 12 publications

(5 citation statements)

References 5 publications

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“…An association between PRP and seronegative arthritis has been reported, with variable clinical features [51–62]. Arthritis can appear before, after, or simultaneously to cutaneous manifestations.…”

Section: Pityriasis Rubra Pilarismentioning

confidence: 99%

“…A highly variable entity, it is further subclassified into six subgroups according to the age of onset, distribution of lesions and clinical course [49,50] (Table 3). An association between PRP and seronegative arthritis has been reported, with variable clinical features [51][52][53][54][55][56][57][58][59][60][61][62]. Arthritis can appear before, after, or simultaneously to cutaneous manifestations.…”

Section: Pityriasis Rubra Pilarismentioning

confidence: 99%

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Beyond plaque psoriasis – pathogenesis and treatment of other psoriasis phenotypes

Iznardo

Puig

2022

Current Opinion in Rheumatology

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Purpose of reviewPsoriasis vulgaris is the commonest presentation of psoriatic disease, but morphologic variants such as pustular psoriasis (PP) and a closely related disease, pityriasis rubra pilaris (PRP), have been known for a long time, have been associated with rheumatologic manifestations indistinguishable from psoriatic arthritis (PsA) that may go unrecognized, and often represent a therapeutic conundrum. There is recent evidence that underlying genetic and pathogenetic differences may provide the basis for newer therapeutic approaches.Recent findingsThis narrative review highlights the clinical, genetic and pathogenetic characteristics of PP and PRP, their association with PsA and recent developments in their treatment, especially with biologic agents targeting IL-36 and other cytokines of pathogenic relevance.SummaryThe clinical manifestations of PP and PRP are less well known to rheumatologists than those of psoriasis, and recent advances in our insight on their pathogenesis may eventually overcome the therapeutic difficulties faced by dermatologists and rheumatologists in the management of these diseases and their rheumatologic manifestations.

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Section: Pityriasis Rubra Pilarismentioning

confidence: 99%

Section: Pityriasis Rubra Pilarismentioning

confidence: 99%

Beyond plaque psoriasis – pathogenesis and treatment of other psoriasis phenotypes

Iznardo

Puig

2022

Current Opinion in Rheumatology

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“…Between 1973 and 2002, there have been seven case reports describing a temporal relationship of onset of arthritis and PRP (Table III) (Aguilar et al, 1973;Duke et al, 1987;Fiallo et al, 1996;Lister et al, 1997;Conaghan et al, 1999;Behr et al, 2002;Nakafusa et al, 2002). With our report, this will make it the eighth case.…”

Section: Rheumatologic Associationsmentioning

confidence: 54%

“…The diseases classified as seronegative arthritides include psoriatic arthritis, ankylosing spondylitis, Bechet's syndrome, and Reiter's disease. In the cases of PRP associated seronegative arthritis, it has been TABLE III Case reports of PRP associated arthritis (Aguilar et al, 1973;Duke et al, 1987;Fiallo et al, 1996;Lister et al, 1997;Conaghan et al, 1999;Nakafusa et al, 2002;Behr et al, 2002) (Aguilar et al, 1973;Duke et al, 1987;Fiallo et al, 1996;Lister et al, 1997;Conaghan et al, 1999;Behr et al, 2002;Nakafusa et al, 2002) speculated by the authors that it may be the same mechanism that occurs in psoriatic arthritis given the close resemblance of PRP to psoriasis. Still, the pathophysiological relationship between psoriasis and seronegative arthritis is not well established.…”

Section: Rheumatologic Associationsmentioning

confidence: 99%

A Review of Pityriasis Rubra Pilaris and Rheumatologic Associations

Chan

Liu

Naguwa

2004

Journal of Immunology Research

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Pityriasis rubra pilaris (PRP) is a rare group of hyperkeratotic, papulosquamous disease that can be acquired or inherited. There have been reported cases of rheumatologic associations, mainly arthritis and dermatomyositis. In this review article, we will explore the clinical presentation and classification, rheumatologic associations and treatment modalities of PRP. In addition, we will also report a case of PRP with seronegative arthritis.Keywords: Pityriasis rubra pilaris; Review; Arthritis; Rheumatologic; Treatment CASE REPORTA 50-year-old East Indian male with a 2-year history of nonspecific knee arthritis presented to his primary care doctor with a new scaly and pruritic rash. It began on the extensor surfaces of the elbow and bilaterally spread onto the forearms. Similar lesions began to appear over the scalp, trunk, axilla and knee. His nails became thickened and hyperpigmented. The patient was diagnosed with psoriasis. With the appearance of the lesions, his knee pain intensified, especially when ascending the stairs. The pain would awaken him at night. During this period, he had stiffening of his extremities. Besides fatigue, he denied any recent acute illnesses, constitutional symptoms, and mucocutaneous or ocular lesions. His past medical history included hypothyroidism and seasonal allergies. He denied food, drug and environmental allergies. His medication list at presentation included levothyroxine and glucosamine and chondroitin. He smoked tobacco occasionally and owned a cat. He had not traveled outside the country recently. His mother had nonspecific arthritis. On physical examination, his vitals were normal. There were no lymphadenopathy, oral lesions and hepatosplenomegaly. Neither joint deformity nor synovitis was appreciated. He had tenderness of the right knee on palpation with mild patellar laxity. He had multiple sharply demarcated redorange scaly plaques over the extensor surfaces of the forearms, axillae, knees and trunk. The plaques were nearly confluent on his trunk with the exception of islands of normal skin. The skin of his palms was thick and dry. Bilaterally, his second and third fingernails were hyperkeratotic with pitting and hyperpigmentation.X-rays of the hands and knees were normal. Complete blood count, complete metabolic panel and urinalysis were normal. The erythrocyte sedimentary rate was 15; antinuclear antibody was 1:160 with a nucleolar pattern. Thyroid stimulating hormone, immunoglobulin and complement levels were normal. Rheumatoid factor, hepatitis panel and RPR were negative. He did not respond to the conventional psoriatic treatment with ultraviolet light therapy UVA and UVB. Eventually, a punch biopsy was performed, and a diagnosis of pityriasis rubra pilaris (PRP) was made. The patient was placed on methotrexate therapy and his arthritis and skin lesions subsequently resolved.

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“…Pityriasis rubra pilaris (PRP) refers to relatively uncommon group of erythematous, scaling dermatologic conditions 1 . There are a few reports of coexistence of PRP with seronegative arthritis or hypothyroidism 2–7 . We present a case of PRP coexisting with both seronegative arthritis and autoimmune thyroiditis.…”

mentioning

confidence: 99%