The skin condition pityriasis rubra pilaris or PRP is very rare and not necessarily dangerous, but it can be unsightly and uncomfortable for sufferers. It affects males and females equally, may show up in childhood or adulthood, and it may affect only a part of the body or a person’s entire body.

The condition itself is not actually curable, although in some cases it does go away on its own and the symptoms can be managed. Understanding its causes, its symptoms, and your treatment options is the best way to handle this condition if you’ve been diagnosed with PRP.

The symptoms of pityriasis rubra pilaris include large reddish orange patches or plaque-like scales on the skin, along with the skin becoming thick and flaking away. The patches are also typically very itchy and uncomfortable. This thickening of the skin may appear on the feet and hands and the sufferer may also notice bumps around the hair follicles. For some, there is also swelling of the legs and feet or other parts of the body affected by the condition.

There are many forms of PRP

There are several different forms of PRP, including classical adult onset. This is the most common type and it begins when a person is an adult, with the symptoms going away after a few years. In very rare cases the symptoms will then return and the condition becomes cyclical, or appearing and disappearing in cycles.

Atypical adult onset is much more rare; this type also appears when a person is an adult but the symptoms last for years, even decades.

Classical juvenile onset is when the condition appears when a sufferer is a child and the symptoms go away within a year. With circumscribed juvenile onset PRP, the symptoms appear before a child reaches puberty and it only appears on their hands, feet, elbows, and knees. These symptoms too typically go away when the child becomes a teenager.

The most difficult form of PRP to treat is HIV-associated. This condition comes on when a person is infected with HIV and because their immune system is so suppressed due to their illness, they in turn have difficulty treating the symptoms.

Causes and treatment of pityriasis rubra pilaris

One challenge in treating pityriasis rubra pilaris is that there is no known definitive cause. Some cases are inherited while others are not. Most cases seem to just appear without any type of cause, and these also then disappear on their own with or without treatment. Some experts suggest that this disease may be due to a defect in how the body processes vitamin A, although this doesn’t explain why the symptoms would come and go as they do.

Some cases of PRP are associated with a type of skin cancer but this is very rare. However, anyone with this condition should get tested and ensure they don’t have melanoma under their PRP patches.

Very often PRP is mistaken for similar skin conditions such as psoriasis or eczema, and is only diagnosed when it doesn’t respond to standard treatment for those conditions. A doctor may also take a skin biopsy, which is when a small part of the skin is cut away and then studied in a lab to determine the real disease causing the dryness and flaking.

The disease itself is not curable but symptoms can be treated with topical creams that contain lactic acid, which help to rid the skin of the rough and scaly patches. Oral vitamin A can also reduce symptoms, or a patient may take a retinoid which is a drug that slows the growth of skin cells.

In some cases light therapy can help; this is when a concentrated ultraviolet light is applied to the affected area which in turn speeds healing.

If you suspect you have pityriasis rubra pilaris or have already been given a diagnosis, be sure you’re in touch with your doctor about your treatment options. Many cases of PRP go away and never come back, but not all. You want to ensure that you treat the condition so that surrounding skin is not affected and so that you don’t suffer unnecessary embarrassment or discomfort over the appearance of your skin during a breakout of the condition.

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