Resolving classic pityriasis rubra pilaris, mimicker of erythema gyratum repens

Abstract

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Transformation from pityriasis rubra pilaris to erythema gyratum repens–like eruption without associated malignancy: A report of 2 cases

“…In reported cases of PRP to EGR-like transformation, all patients have been white, with the exception of one Afro-Caribbean man; all but 1 of the patients were men. 1 , 3 , 4 , 5 , 6 As discussed above, EGR-like eruptions have been reported in immune-mediated conditions. 1 , 2 CARD14, a known activator of NF-κB signaling implicated in inflammatory disorders, is expressed in both familial PRP and familial psoriasis.…”

“…The transformation from PRP to an EGR-like eruption has been reported 8 times in the literature. 1 , 3 , 4 , 5 , 6 In none of these cases was this transformation indicative of internal malignancy, despite thorough investigations in some cases. 1 In all subjects, the eruption appeared during the resolving phase of PRP.…”

“… 1 In all subjects, the eruption appeared during the resolving phase of PRP. 1 , 3 , 4 , 5 , 6 What drives this transition remains unknown. Of our 2 patients reported above, one completely cleared the altered eruption, whereas the other still displays persistent EGR, now 8 months after initial transformation.…”

“… 4 , 5 One patient was treated with infliximab, followed by secukinumab, remaining on acitretin 25 to 50 mg/d throughout. 6 Secukinumab was ceased after 9 months; however, as his PRP resolved, he had an EGR-like eruption. 6 Five months later, the new eruption persisted (as in our patient), and he was continued on acitretin at a reduced dose of 10 mg/d.…”

“… 6 Secukinumab was ceased after 9 months; however, as his PRP resolved, he had an EGR-like eruption. 6 Five months later, the new eruption persisted (as in our patient), and he was continued on acitretin at a reduced dose of 10 mg/d. 6 …”