Misdiagnosed Pityriasis Rubra Pilaris Successfully Managed With Isotretinoin: A Case Series

Abstract

Being a rare inflammatory, hyperproliferative dermatosis, diagnosing pityriasis rubra pilaris (PRP) can be a challenge to many clinicians. Our case reports aim to demonstrate that PRP is frequently diagnosed and managed as atopic dermatitis (AD) and that distinguishing features on dermoscopy, and biopsy can help diagnose this rare disease. The study also aims to show that PRP can be successfully treated with Isotretinoin. Our case series aims to describe two cases of PRP, initially diagnosed as AD and managed with topical corticosteroids. Being the first case series in the literature to describe the incidences of diagnosing PRP as AD portrays the significance of utilizing dermoscopy and biopsy as tools to confirm this diagnosis for appropriate management. Although PRP is a rare diagnosis, dermoscopy and biopsy can help confirm the disease. Management with isotretinoin will most likely have successful outcomes in those patients.

Updates on Pityriasis Rubra Pilaris: A Scoping Review

“… 38 A recently published study reported 2 cases where individuals initially diagnosed with atopic dermatitis were refractory to initial therapeutic efforts, resulting in repeat biopsy and correct diagnosis of PRP. 39 Given the difficulty of differentiating PRP from other dermatoses, especially during the early stages, clinicians should always consider different diagnoses and repeat skin biopsies for treatment-resistant papulosquamous eruptions.…”

Oral Isotretinoin and Its Uses in Dermatology: A Review

“… 95 Same as a recent case series report revealed the effective use of isotretinoin (10–20 mg/day for 6–12 weeks) in treating two cases of PRP that were initially misdiagnosed as atopic dermatitis. 96 …”