Pityriasis rubra pilaris (PRP) is a rare papulosquamous dermatosis of uncertain etiology. Of the six subtypes described, the most frequent form is adult type I, which typically involves erythroderma and islets of respected skin, follicular hyperkeratosis and orange palmoplantar keratoderma. This entity continues to be a therapeutic challenge, as F I G U R E 1 Pityriasis rubra pilaris before and after treatment with ixekizumab. A-C, Exfoliative erythroderma with intense desquamation and orange palmoplantar keratoderma. D-F, After 6 months of treatment with ixekizumab