Type II Pityriasis Rubra Pilaris Associated with Grave's Disease-Case Report

Abstract

Introduction Pityriasis Rubra Pilaris (PRP) is a chronic inflammatory dermatological disease with no definite underlying cause to date, but many reports have linked it with autoimmune disorders, HIV infection, internal malignancies, streptococcal infections, hypothyroidism, and genetic mutation in a familial form. The relation to hypothyroidism is partially established. This link has been reported in medical literature; researchers suggested assessing the thyroid status as part of the PRP workup. We are reporting, for the first time, a case of PRP in association with Grave’s disease, which subsided after gaining control of the hyperthyroid status. Case presentation: A 24-year-old Syrian female presented with symptoms and signs of hyperthyroidism, as well as extensive skin dryness, hyperkeratosis, and skin breaks at the hands and feet associated with widespread squamous plaques over the extensor surfaces of the joints, which were not responding to any type of emollients. She was diagnosed with Grave’s disease and PRP and subsequently treated with anti-thyroid medications followed by radioactive iodine therapy, after which the PRP features improved remarkably. Conclusions: This is the first report of PRP in association with Grave’s disease. This link needs to be confirmed with more case reports. We agree with the previous suggestion of having thyroid function assessed cases of PRP refractory to traditional therapies. In those patients whose PRP is associated with thyroid dysfunction, in addition to topical agents, normalization of thyroid status should be attempted and might be beneficial.