Pityriasis Rubra Pilaris with Preceding Cytomegalovirus Infection

Abstract

Pityriasis rubra pilaris (PRP) is a papulosquamous disorder comprising 6 clinical types. Some factors – including abnormal vitamin A metabolism, internal malignancies, autoimmune diseases, infection and trauma – are thought to be involved in the etiology. Recently, human immunodeficiency virus (HIV)-associated PRP has been reported to have distinct clinical features, such as nodulocystic acne and lichen spinulosus alongside PRP. We report here the case of a 38-year-old female with onset of classical PRP after a high fever. Virological studies indicated that the patient had primary systemic cytomegalovirus (CMV) infection and not HIV infection. Our case suggested that primary CMV infection might have triggered typical PRP that was clinically different from HIV-associated PRP.

Pityriasis rubra pilaris: algorithms for diagnosis and treatment

“…[6][7][8] Accepted triggers of PRP are viral or bacterial infections. [9][10][11][12][13][14] The successful treatment of PRP with antiretroviral drugs in HIV-positive patients can be especially placed as a standard therapeutic measure. 15 Anecdotal reports suggest that autoimmune diseases 16,17 and neoplasias [18][19][20][21][22][23] can trigger PRP.…”

“…Meanwhile, the understanding is that PRP is not a consequence of vitamin A deficiency, but rather it is responsive to alitretinoin, isotretinoin etretinate, and vitamin A . Accepted triggers of PRP are viral or bacterial infections . The successful treatment of PRP with antiretroviral drugs in HIV‐positive patients can be especially placed as a standard therapeutic measure .…”

Case of pityriasis rubra pilaris progressed to generalized erythroderma following blockade of interleukin‐17A, but improved after blockade of interleukin‐12/23 p40

“…On the other hand, viral infections may also trigger PRP. Kawara et al . reported a case of PRP that occurred following cytomegalovirus infection.…”

“…On the other hand, viral infections may also trigger PRP. Kawara et al 12 reported a case of PRP that occurred following cytomegalovirus infection. They indicated that some viral or bacterial infection may produce modification of immune responses in the Th1 pathway and inflammation of skin as a target, and may lead to the development of PRP.…”

Pityriasis Rubra Pilaris: Treatment with Biologics – A New Promising Therapy?

“…Furthermore, ultraviolet B phototherapy exacerbated the disease in some patients [7]. Recent observations also point to triggering comorbidities including HIV or cytomegalovirus infection, chronic hepatitis C, myasthenia gravis, sprue, hypothyroidism, neoplasia or trauma [3,8]. Leukemia-associated forms have been reported repeatedly [9].…”