Shobhan Manoharan, MB BS. Stephen White, FRCP. Krishna Gumparthy, MRCPath.
Successful treatment of type I adult-onset pityriasis rubra pilaris with infliximab
Article first published online: 4 APR 2006
Australasian Journal of Dermatology
Volume 47, Issue 2, pages 124–129, May 2006
How to Cite
Manoharan, S., White, S. and Gumparthy, K. (2006), Successful treatment of type I adult-onset pityriasis rubra pilaris with infliximab. Australasian Journal of Dermatology, 47: 124–129. doi: 10.1111/j.1440-0960.2006.00247.x
- Issue published online: 4 APR 2006
- Article first published online: 4 APR 2006
- Submitted 27 June 2005; accepted 9 November 2005.
- dermatitis exfoliativa;
- fumaric acid;
- monoclonal antibody;
- mycophenolate mofetil;
- tumour necrosis factor-α
A 59-year-old woman presented with a painful, pruritic eruption that had commenced as an erythematous, dry patch on the upper back but progressed to erythroderma. Examination revealed orange-tinged erythroderma, scalp scaling, ectropion, palmoplantar keratoderma and nail changes. A diagnosis of type I adult-onset pityriasis rubra pilaris was made, and a subsequent skin biopsy was consistent with this. She was treated with a number of topical and systemic agents with minimal improvement or major side-effects. The patient was then treated with intravenous infliximab 5 mg/kg. She improved dramatically within 2 weeks and was no longer erythrodermic. Five further infusions resulted in additional improvement. Methotrexate was briefly added to the regime, but was ceased owing to nausea. Topical tar and keratolytics were used on the scalp. The patient was left with minimal disease activity and was maintained on emollients.