Pityriasis rubra pilaris: the clinical context of acantholysis and other histologic features

Christine J. Ko*, Leonard M. Milstone, Jaehyuk Choi, Jennifer M. Mcniff

*Corresponding author for this work

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background Acantholysis has been described in biopsies of pityriasis rubra pilaris (PRP), but this has not been emphasized in the dermatology literature. It is helpful for dermatologists to associate acantholysis with PRP in the correct clinical setting. Objective This study aims to further elucidate the clinical context and associated histologic features of acantholysis in PRP. Methods Eight cases of PRP with acantholysis, 16 other cases of PRP, 26 cases of psoriasis, and 17 cases of erythroderma of different causes were studied in an academic setting. Results The presence of acantholysis initially confounded the diagnosis in two cases of PRP. Acantholysis was focal or extensive and resembled Darier's disease, Hailey-Hailey disease, or pemphigus vulgaris. Acantholysis was seen in biopsies from early, isolated papulosquamous lesions from the trunk as well as from erythroderma. By comparison, 26 cases of psoriasis and 17 cases of erythroderma showed only focal acantholysis in two cases of erythroderma. Conclusions Acantholysis is a histologic feature of PRP and can serve as a histologic clue to the diagnosis of PRP before the onset of erythroderma. Eosinophils and/or a lichenoid infiltrate may also be evident.

Original languageEnglish (US)
Pages (from-to)1480-1485
Number of pages6
JournalInternational Journal of Dermatology
Volume50
Issue number12
DOIs
StatePublished - Dec 1 2011

Fingerprint

Pityriasis Rubra Pilaris
Acantholysis
Exfoliative Dermatitis
Psoriasis
Benign Familial Pemphigus
Darier Disease
Biopsy
Pemphigus
Dermatology
Eosinophils

ASJC Scopus subject areas

  • Dermatology

Cite this

Ko, Christine J. ; Milstone, Leonard M. ; Choi, Jaehyuk ; Mcniff, Jennifer M. / Pityriasis rubra pilaris : the clinical context of acantholysis and other histologic features. In: International Journal of Dermatology. 2011 ; Vol. 50, No. 12. pp. 1480-1485.
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Pityriasis rubra pilaris : the clinical context of acantholysis and other histologic features. / Ko, Christine J.; Milstone, Leonard M.; Choi, Jaehyuk; Mcniff, Jennifer M.

In: International Journal of Dermatology, Vol. 50, No. 12, 01.12.2011, p. 1480-1485.

Research output: Contribution to journalArticle

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T1 - Pityriasis rubra pilaris

T2 - the clinical context of acantholysis and other histologic features

AU - Ko, Christine J.

AU - Milstone, Leonard M.

AU - Choi, Jaehyuk

AU - Mcniff, Jennifer M.

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N2 - Background Acantholysis has been described in biopsies of pityriasis rubra pilaris (PRP), but this has not been emphasized in the dermatology literature. It is helpful for dermatologists to associate acantholysis with PRP in the correct clinical setting. Objective This study aims to further elucidate the clinical context and associated histologic features of acantholysis in PRP. Methods Eight cases of PRP with acantholysis, 16 other cases of PRP, 26 cases of psoriasis, and 17 cases of erythroderma of different causes were studied in an academic setting. Results The presence of acantholysis initially confounded the diagnosis in two cases of PRP. Acantholysis was focal or extensive and resembled Darier's disease, Hailey-Hailey disease, or pemphigus vulgaris. Acantholysis was seen in biopsies from early, isolated papulosquamous lesions from the trunk as well as from erythroderma. By comparison, 26 cases of psoriasis and 17 cases of erythroderma showed only focal acantholysis in two cases of erythroderma. Conclusions Acantholysis is a histologic feature of PRP and can serve as a histologic clue to the diagnosis of PRP before the onset of erythroderma. Eosinophils and/or a lichenoid infiltrate may also be evident.

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