Follicular Hyperkeratosis Research Articles

The results of using Blue cap® foam for skin care with signs of xerosis

A significant increase in the severity of clinical manifestations of various dermatoses accompanied by dry skin often increases the feeling of discomfort and itching of the skin, significantly reducing the patient's quality of life. This leads to the search for effective ways to correct the dryness of the skin and maintain the proper functioning of the epidermal barrier of the skin in various dermatoses. The aim of the study was to study the effect of using a combined emollient, which includes components of a classic emollient (with the inclusion of ceramides and substances with moisturizing and softening effects), as well as substances with antiseptic and fungistatic effects. The results of treatment of 100 patients with skin diseases and conditions accompanied by dry skin and itching were analyzed. The study group included patients with acne undergoing treatment with retinoids and external preparations with an irritating effect, patients with atopic dermatitis in remission, patients with seborrheic dermatitis, rosacea, follicular hyperkeratosis, and skin xerosis. Using the method of corneometry, the dynamics of changes in skin hydration during the use of a combined moisturizer and changes in the indicators of the dermatological index of the quality of life of patients were studied. The data obtained showed a pronounced increase in skin hydration in terms of corneometry after 2 weeks of using an emollient (by an average of 31.6 units or 160%), and after a month of observation, the changes amounted to 36.7 conv. units, i.e. increased by 185%, which proves the effectiveness of using Blue cap® foam to normalize skin hydration. The level of the dermatological index of quality of life during this period decreased from 9.9±0.2 to 7.2±0.2 points, i.e. by 2.7 points or 27%,what also indicates an improvement in the subjective attitude of patients and promotion quality of life of patients. In the course of the study, a significant improvement in skin hydration when using the combined Blue cap® foam to correct signs of skin xerosis was proven. In the case of dermatoses accompanied by itching associated with dry skin, a marked reduction in itching was noticed, as well as a significant improvement in the quality of life of the patient after a month of using the combined moisturizer.

Industrial ecology and skin diseases

Technogenic effects on the production of oil, coal tar, other hydrocarbons and products of their processing can lead to diseases of the sebaceous glands. Gum-related factors trigger common links in the pathogenesis of vulgar and oily acne, which are inflammation, increased sebum production, excessive follicular hyperkeratosis. There is a description of the clinical manifestations of severe oily acne in a railway worker on previously unchanged skin. We also have a description of the severe stage of the course of vulgar acne in the assistant engineer of the railway, who has a genetic predisposition, also has a history of juvenile acne of mild severity. Chemical factors such as a mixture of hydrocarbons, phenol, creosote, asbestos-containing dust can provoke oily acne in a railway worker. Oxides of nitrogen, carbon, sulfur, nitrogen dioxide, technical mixtures of hydrocarbons, violation of physiological rhythms of nutrition, sleep, rest, severity and intensity of the labor process, constant stress can lead to a relapse of vulgar acne with a more severe course in workers of locomotive crews. The given clinical examples reveal the need for interdisciplinary interaction of dermatologists-venereologists and occupational pathologists in the treatment of skin pathology in workers of harmful industries.

FORMULASI SEDIAAN CREAM DAN UJI AKTIVITAS ANTIBAKTERI PADA EKSTRAK ETANOL KOMBINASI KULIT PISANG (Musa paradisiaca) DAN KULIT NANAS (Ananas comosus) TERHADAP BAKTERI PENYEBAB JERAWAT Propionibacterium acnes

Background: Acne vulgaris is a chronic inflammatory skin disease with a complex pathogenesis, involving sebaceous glands, follicular hyperkeratosis, bacterial overgrowth, immune and inflammatory responses. Objective: This formulate the ethanol extract of banana peel and pineapple peel into cream preparations and to test the effective antibacterial activity of the combination of banana peel and pineapple peel ethanol extract cream against Propionibacterium acnes. Methods: This research was conducted experimentally with maceration extraction using 70% ethanol as solvent. Acne cream is made with a concentration ratio between (Banana peel: Pineapple peel) namely F1 (Cream Base), F2 (5%:15%), F3 (7.5%:12.5%), F4 (10%:10% ), F5 (12.5%:7.5%), F6 (15%;5%), F7 (20%:0%) and F8 (0%;20%). Then, the physical stability test was carried out in the form of organoleptic test, viscosity test, pH test, homogeneity test, spreadability test and cream type test. Followed by testing the bacteria Propionibacterium acnes in Na media. Results: The antibacterial activity test on F3 showed that the diameter of 20.18 mm was relatively larger than F1 of 0mm, F2 of 18.63 mm, F4 of 18.38 mm, F5 of 16.48 mm, F6 of 18.28 mm, F7 of 13.91 mm and The F8 is 16.11 mm. Conclusion: Cream preparations from formula 1 to formula 8 the cream stability organoleptic test, viscosity test, pH test, homogeneity test, test spreadability and cream type test. The cream preparation in formula 3 has the widest diameter for antibacterial activity compared to other formulas.

A Case of Widespread Keratosis Pilaris-like eruption Associated with Nilotinib Used for Chronic Myelogenous Leukemia

Keratosis pilaris is a skin disorder which is characterized by follicular hyperkeratosis. It is most commonly seen in patients with atopic dermatitis and ichthyosis vulgaris. Abnormal keratinization of the hair follicle leads to plugging and bumpy, rough appearance. Upper extensor arms, thighs, buttocks and cheeks are most commonly affected by the disease. Even though keratosis pilaris is associated with autosomal dominant inheritance; it may also be seen as a side effect of various targeted cancer therapies including BRAF and tyrosine kinase inhibitors. Herein, we would like to present a case of keratosis pilaris that had developed secondary to nilotinib treatment.

S2616 Melena: An Uncommon Presentation of Scurvy

Introduction: Scurvy is the clinical manifestation of vitamin C deficiency and presents with hemorrhage (petechiae, ecchymoses, bleeding mucosa), follicular hyperkeratosis, hemolytic anemia, hypochondriasis, hysteria, depression, and fatigue. Scurvy is a rare diagnosis in industrialized countries; however, it can be seen in alcoholic, elderly, and institutionalized patients or those following fad diets or suffering from malabsorptive disorders. The association of scurvy and GI pathology is rare, but it exists. There have been reported cases of scurvy presenting as GI bleed and even as the initial manifestation of Whipple’s disease. Case Description/Methods: A 71-year-old female with past medical history of systemic lupus erythematosus, carcinoid tumor of the small bowel and abnormal bruising presents to the hospital with worsening purpura and intermittent polyarthralgia affecting her feet, ankles, knees, hips, shoulders, and elbows. Labs were significant for anemia of 8.25 and mildly elevated CRP and ESR of 5.9 and 30 respectively. During hospitalization, the patient had multiple black bowel movements and her hemoglobin dropped to 6.8. Iron studies were significant for iron deficiency. She was transfused and underwent EGD and colonoscopy. EGD showed characteristic findings of gastric antral vascular ectasia (Figure 1) which was treated with APC and colonoscopy revealed erythematous mucosa throughout the entire colon (Figure 1). Biopsy of the colon mucosa was unremarkable. The patient was discharged with dermatology follow up for biopsy of purpuric skin lesions. After discharge, patient's labs resulted and showed an undetectable level of Vitamin C. She was seen at follow up by her PCP and treatment was started. Discussion: The water-soluble vitamin C plays a crucial component in collagen synthesis by activating hydrolases that form stabilizing components of the collagen triple-helix structure. When deficient, small vessels in the skin and mucosa become fragile resulting in submucosal hemorrhage in the stomach, duodenum and colon that presents as hematochezia or melena. Treatment consists of dietary modification and intravenous vitamin C replacement with resolution of lesions in only a few days. Vitamin C is replaced daily and generally normalizes in 3-4 weeks. This case demonstrates an unusual presentation of scurvy in the form of GI bleed. It is important for gastroenterologists to consider scurvy in the differential diagnosis of patients presenting with GI bleed, purpura and polyarthralgia.Figure 1.: (A) EGD images of mucosal hemorrhage seen in scurvy (B) Colonoscopy images of mucosal hemorrhage seen in scurvy.

Spinular follicular keratosis of Siemens associated with wooly hair in two sisters: Trichoscopic description and anatomopathological correlation

Spinular follicular keratosis (SFK) is a rare X-linked inherited disorder of keratinization characterized by diffuse follicular hyperkeratosis and progressive scarring alopecia of the scalp, eyebrows, and eyelashes. Trichoscopy is a non-invasive dermatological tool that has improved the differential diagnosis of hair pathologies. In fact, dermoscopic models have been developed for several entities of scalp diseases, allowing early diagnostic confirmation and rapid action without the need for histopathology, as well as good follow-up for patients and signs of pathological activity. To date, the specific trichoscopic signs of KFSD have not been developed. Herein, we report the case of KFSD of Siemens in two sisters associated with wooly hair. We employed trichoscopy as a highly useful tool for diagnosis, then performed an anatomopathological study to confirm the diagnosis and explain the signs found on trichoscopy.

32460 Pityriasis rubra pilaris transcriptomics identifies mechanisms of treatment resistance

Pityriasis rubra pilaris (PRP) is a rare papulosquamous dermatosis characterized by follicular hyperkeratosis, orange-red plaques, scalp scaling and palmar plantar keratoderma, though its presentation is variable. Understanding of the pathogenesis of PRP remains incomplete, but interleukin 17 (IL-17) has been implicated to play a significant role. In this prospective trial of 12 patients with PRP, secukinumab 300 mg was administered subcutaneously once daily for 4 weeks then every 4 weeks for a total of 24 weeks.

A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF MRITTIKA LEPA AND LODHRADI LEPA IN YUVANAPIDIKA W.S.R TO ACNE VULGARIS

Acne vulgaris is a condition where it is characterized by Microcomedones, the earliest lesions of acne, appear at adrenarche, when androgens of adrenal origin begin to stimulate follicular hyperkeratosis and sebaceous hyperplasia in pilosebaceous units on the face.1Mud is one of the rarely used natural modes of treatment in any of the cases. But Black Mud is very useful in conditions of skin ailments.Lodhradilepa has anti-inflammatory action.Therefore, the study was planned to observe the comparative effect of mrittikalepa and lodhradilepa in the management of Acne vulgaris. In the study 30 patients were selected according the classical signs and symptoms of Yuvanapidika& divided into two equal groups comprising of 15 patients in each group. In Group A, 4 patients (26.67%) got mild relief, 3 patients (20%) got moderate relief and 8 patients (53.33%) got marked relief. In Group B, 4 patients (26.67%) got mild relief, 6 patients (40%) got moderate relief and 5 patients (33.33%) got marked relief.Black Mud easily combines with water, absorbs all the seven colours of skin and does not have any adverse effects. It gives cooling effect to the body, because of its moisture retention capacity and it increases the blood circulation and energizes the various skin tissues.2The drug Lodhra, Vachaand Dhanyakaare Kushtagna, Vranaropaka,Vedanasthapaka,Shotahara3might have resulted in good relief.

The spectrum of fibrosing alopecias

AbstractLichen planopilaris (LPP) is a primary lymphocytic cicatricial alopecia considered the most common cause of scarring hair loss in adults. It has been classified into three clinical variants: classical LPP, frontal fibrosing alopecia (FFA) and Graham Little‐Piccardi‐Lassueur syndrome. Classical LPP usually presents as a circumscribed cicatricial patch on the vertex and FFA as a band‐like scarring alopecia of the frontotemporal hairline. Fibrosing alopecia in a pattern distribution (FAPD) and lichen planopilaris diffuse pattern (LPPDP) are two recently described subtypes of LPP that exhibit a diffuse involvement of the androgen‐dependent region or the whole scalp, respectively. Classical LPP, FFA, FAPD and LPPDP share trichoscopic (cicatricial areas, absence of follicular openings, perifollicular erythema and hyperkeratosis) and histologic features (interface dermatitis involving follicular epithelium and concentric fibrosing around the isthmus and infundibulum). The remarkable clinical and histological overlap between these entities has led to the concept that these diseases exist along a spectrum. In the effort to identify classical LPP, FFA, FAPD and LPPDP with an umbrella term, we suggest to use ‘lichenoid alopecias’, as the distinguishing hallmark of these diseases is the lichenoid bandlike inflammatory infiltrate in the superficial dermis involving the infundibulum and isthmus of the hair follicle.

Histopathology of Hidradenitis Suppurativa: A Systematic Review.

Hidradenitis suppurativa (HS) is a chronic inflammatory scarring disease felt to be related to occlusion of the hair follicle unit in intertriginous areas. We perform a systematic review on HS histopathology to evaluate current knowledge and discuss future directions. PubMed and Scopus databases were searched for relevant articles published from January 1985 to January 2021 that discussed the pathology of HS. Additional articles were identified by hand-searching, which entailed manually scanning selected journals. A total of 355 citations were identified in the primary search within the main databases. Two hundred and seventy-nine articles were excluded after a review of titles, abstracts, and duplicates. Sixty-one studies did not meet the inclusion criteria or were found to be duplicates, resulting in a total of 15 articles for analysis. Three articles were hand-searched. This comprehensive systematic review of the histopathology of HS confirms a high prevalence of follicular occlusion, follicular hyperkeratosis, and hyperplasia of the follicular epithelium. These findings support the central role of follicular occlusion in the development and progression of HS while providing a potential path to directing therapeutics against follicular occlusion.

Prevalence of lichen planopilaris in the United States: A cross-sectional study of the All of Us research program

To the Editor: Lichen planopilaris (LPP) is a variant of lichen planus characterized by follicular hyperkeratosis and T-lymphocyte mediated perifollicular inflammation that often progresses to irreversible, scarring alopecia. There is a paucity of epidemiological data on LPP, with current estimates of LPP prevalence being based on single-center and single-city studies.1-4 There are no studies that evaluate LPP prevalence in a diverse, nationwide cohort of American patients. Here, we aimed to estimate the prevalence of LPP using the All of Us database, a recently launched initiative by the National Institutes of Health that strives to include communities that have been historically underrepresented in research.

Histology of Skin Alterations in Lupus Erythematosus

Abstract Lupus erythematosus is an autoimmune connective tissue disorder showing a broad spectrum of clinical manifestations. The aim of this study was to assess the correlation of skin histology and different types of lupus erythematosus. Materials and methods: Fifty-one skin specimens were assessed from 39 female and 12 male patients with acute, subcutaneous and chronic lupus erythematosus, diagnosed and treated in the Department of Dermatology and Venereology, Alexandrovska University Hospital for a 4-year period. Results: Follicular hyperkeratosis, epidermal atrophy, vacuolar degeneration and interface dermatitis were the most frequently observed lesions in chronic cutaneous lupus erythematosus while diffuse hyperkeratosis, epidermal atrophy and indistinct interface dermatitis in the dermis were predominant in subacute cutaneous lupus erythematosus. Lupus tumidus, a rare intermittent variant of cutaneous lupus erythematosus, showed almost no epidermal involvement and mucin deposition in the dermis. However, in one of our lupus tumidus patients the disease progressed to a systemic form with histological changes of acute cutaneous lupus erythematosus including atrophy, dermal-epidermal smoothing and lymphocytic infiltration in the dermis. Of note, a few patients showed histological changes of urticarial vasculitis-like and rheumatic-like patterns. Conclusion: The correlation of clinical course, histopathological findings and immunological tests are of vital importance for the correct diagnosis and follow up of patients with lupus erythematodes, thus preventing complications and improving their quality of life.

Spinulosis revealing dermatomyositis relapse: A new description of Wong’s dermatomyositis

Sir, Dermatomyositis (DM) is a systemic autoimmune disease affecting characteristically the skin and muscles. The typical cutaneous features include Gottron’s papules, a heliotrope rash, and edema of the eyelids. Spinulosis is an unusual sign, not raising suspicion for a DM diagnosis. Herein, we report a case of DM relapsing as Wong’s dermatomyositis (WDM) as an isolated spinulosic eruption. A 42-year-old female presented with a pruritic papular eruption involving both arms and the back persistent for the last two months. An anamnesis included a history of DM diagnosed five years earlier, in complete remission under the administration of corticosteroids for three years. A physical examination revealed erythematous and violaceous scaly plaques resulting from confluent follicular papules, resembling pityriasis rubra pilaris (PRP) on the lateral sides of the arms (Fig. 1) and the upper back (Fig. 2). Muscular testing was subnormal and the general status was conserved. Laboratory findings revealed a high level of blood CPK (3×N), LDH (4×N), and ASAT (3.5×N), while electromyography displayed myogenic changes. A muscular biopsy revealed necrotic muscular cells with perifascicular atrophy and lymphocytic inflammatory infiltrate. A histological skin examination found follicular hyperkeratosis with perifollicular interface dermatitis and interstitial mucin deposits in the dermis (Fig. 3). Based on these findings, the diagnosis of WDM was retained. A malignancy workup was negative. Corticosteroid therapy was initiated with prednisone 1 mg/kg/day in combination with hydroxychloroquine 200 mg twice a day, resulting in a remarkable clinical and biological improvement.WDM is characterized by the presence of PRP-like follicular papules in a patient with dermatomyositis (DM) [1]. Some authors suggest that this exceptional presentation should be considered a true association of DM with PRP rather than a variant of DM [2]. In this rare form, spinulosic lesions are mainly located on the trunk or limbs with occasional palmoplantar keratoderma [2]. Follicular lesions are usually associated with the typical signs of DM but some cases of isolated PRP features related to WDM have been reported [3]. To our knowledge, none has been reported as a relapse of a previous classic DM. Our patient relapsed showing spinulosic lesions absent in the prior episode five years earlier, not displaying at this time any classic cutaneous signs of DM. Such puzzling presentations are very unusual and may be confusing for physicians. In our patient, the diagnosis was retained on the basis of the histopathological findings of interface dermatitis and interstitial mucin deposits in the dermis, increased serum levels of muscle enzymes with a myogenic electromyographic pattern, the typical muscular histological changes, and a medical history of DM diagnosed five years earlier. In WDM, histology usually reveals follicular hyperkeratosis with keratotic plugs filling dilated follicular infundibula, which may raise several differential diagnoses, including PRP, discoid lupus erythematosus (DLE), and, to a lesser degree, follicular psoriasis and keratosis pilaris [4]. Interface dermatitis and mucin deposits, as in our patient, are the hallmarks of distinguishing DM from PRP, follicular psoriasis, and keratosis pilaris. Although these findings may also be observed in DLE [4], in our patient, there were no clinical or histological arguments supporting DLE rather than a diagnosis of DM. Myositis as, well as interstitial lung disease, appears to be comparable to the classic variant [5]. The risk of associated internal malignancy is unknown but could be lower than in the classic form [4]. Treatment and management do not differ from classic dermatomyositis.

Lichen planopilaris: a case report

Viktor Migunov1 1Vilnius University, Faculty of Medicine Abstract Background. Lichen planopilaris is an immune-mediated scarring alopecia. The disease usually manifests as pruritic or painful multifocal patches of alopecia with perifollicular erythema and follicular hyperkeratosis. The course of lichen planopilaris is usually unpredictable, and currently available treatment options do not lead to hair regrowth, unless the […]

Pelodera strongyloides in the critically endangered Apennine brown bear (Ursus arctos marsicanus)

Skin biopsies from 20 Apennine brown bears (Ursus arctos marsicanus), 17 of which displaying skin lesions, were investigated by histopathology.Different degrees of dermatitis characterized by folliculitis and furunculosis accompanied by epidermal hyperplasia and epidermal and follicular hyperkeratosis were detected. In the most severe lesions, the superimposition of traumatic wounds, probably self-induced by scratching, was observed. In 8 out of 17 (47.0%) affected bears, cross- and longitudinally-sectioned nematode larvae were present within the lumen of hair follicles, whose localization and morphological characteristics were consistent with Pelodera strongyloides.P. strongyloides is a free-living saprophytic nematode whose third-stage larvae can invade the skin causing pruritic dermatitis in several mammalian species. This is the first report of Pelodera infection in the brown bear. Although capable of causing primary dermatitis, the finding of Pelodera is not sufficient to conclude that it is the cause of the lesions observed in bears. Nevertheless, the high prevalence of the infection is indicative of a diffuse phenomenon that requires further specific investigations given the interest and conservational relevance of this relict bear population.

Efficacy of tacrolimus 0.1% ointment in keratosis pilaris: A prospective hospital based interventional study

Background: Keratosis pilaris (KP) is cosmetically displeasing and psychologically distressing. Many treatments are being tried, but they have not been very effective. There is a need for the evaluation of newer therapeutic modalities. Aim: Evaluation of efficacy and safety of tacrolimus 0.1% ointment in KP. Methods: A prospective hospital-based interventional study was conducted on 60 KP patients who presented to our outpatient department between January 2017 and June 2018. All patients were advised to apply tacrolimus ointment 0.1% twice daily to the right arm and petrolatum ointment twice daily to the left arm, over a period of 4 weeks. The treated sites were assessed using the investigator's global assessment (IGA) scale and comparing patient satisfaction scores at baseline and at the end of the treatment. Clinical and dermoscopic pictures were taken at baseline and at the end of the treatment. Results: Fifty-one patients completed the study. The IGA mean score was reduced by 0.58 in the tacrolimus group, compared to 0.39 in the petrolatum group. Although there was a statistically significant improvement in each arm, the difference in improvement between the right and left arms was not significant. However, the patient satisfaction score was higher in the tacrolimus group. Dermoscopy showed an improvement in the absence of follicular hyperkeratosis and erythema. Conclusion: Tacrolimus 0.1% ointment is an alternative and safe treatment in the treatment of KP. It has shown moderately higher patient satisfaction as compared to petrolatum and was tolerated well.

096 Isotretinoin Use in Pityriasis Rubra Pilaris

Pityriasis rubra pilaris is an uncommon papulosquamous inflammatory dermatosis with an etiopathogenesis still insufficiently known. There are six subtypes that differ from each other by the age of onset, the distribution and morphology of the lesions, the natural evolution of the disease and the association with HIV infection. Type I is the most common form in adults, while types III and IV are the most common in children. The following clinical manifestations are described in all subtypes in varying proportions: follicular hyperkeratosis, scaly orange-red plaques and palmoplantar hyperkeratosis.

Polymorphisms in Genes Involved in Steroidogenesis in the Development of Severe Acne

Background: Acne is a multifactorial disease, in the pathogenesis of which one of the leading factors is the excessive effect of androgens on the hair follicles (HFs) and sebaceous glands (SGs), along with hypersecretion of sebum, pathological follicular hyperkeratosis and an inflammatory response. The search for genotypic markers in patients with varying severity of acne is a difficult task due to the multifactorial pathogenesis and the role of trigger factors in the formation of acne. The aim of this study was to determine SNPs within 3 genes involved in steroidogenesis (MVK, ARPC1B, and CA2) in patients with severe acne. Methods and Results: The study included 70 patients (42 men and 28 women) aged between 15 and 46 years (the median age - 22.1 years). The main group (MG) included 50 patients (29 men and 21 women) with severe acne. The control group (CG) consisted of 20 apparently healthy individuals (13 men and 7 women). Molecular-genetic diagnostics was carried out by the method of high-throughput DNA sequencing (next-generation sequencing). Our study showed that severe acne is associated with 12 polymorphic loci of the MVK gene (4 SNPs in exons and 8 SNPs in introns), 7 SNPs of the ARPC1B gene (2 SNPs in exons and 5 SNPs in introns), and 9 SNPs of the CA2 gene (3 SNPs in exons and 6 SNPs in introns). Conclusion: The revealed features of the SNPs within the MVK, ARPC1B, and CA2 genes in patients with severe acne probably indicate a hereditary determination of steroidogenesis in acne.

An Epidemic of Scurvy, Identified Based on Lower Extremity Swelling, in a Southern Ethiopian Prison.

In October 2016, we received reports of five deaths among prisoners with leg swelling of unknown etiology in southwestern Ethiopia. A descriptive cross-sectional study was conducted to investigate the outbreak. A suspected case was defined as a prisoner with leg swelling of unknown etiology noted between May 15, 2016 and November 29, 2016. A total of 118 suspected cases were identified with unilateral or bilateral leg swelling without an identifiable cause from a total of 2,790 prisoners. Eight of the suspected cases were thoroughly examined, and seven of these suspected cases had clinical findings consistent with scurvy. Three of the clinical cases had undetectable vitamin C levels in the serum. The attack rate for the prison was 4.2% (118/2,790), and 11 deaths were identified, making the case fatality rate 9.3% (11/118). Clinical cases of scurvy had symptoms of fatigue, myalgia, arthralgia, and signs of follicular hyperkeratosis, petechiae, peripheral edema, and oral lesions. All clinical cases had severe anemia with hemoglobin < 6.0 g/dL. The diet provided by the prison excluded fruits and vegetables. Scurvy was determined to be the cause of the outbreak, and vitamin C supplementation was promptly initiated. All symptomatic prisoners improved, and no further cases were identified in a 4-week follow-up period of active surveillance.

Pityriasis Rubra Pilaris Response to IL-17A Inhibition Is Associated with IL-17C and CCL20 Protein Levels

Pityriasis rubra pilaris (PRP) is a rare, severe inflammatory skin disease associated with high morbidity and debilitating effects on QOL (Eastham et al., 2019; Ross et al., 2016). Classical features include follicular hyperkeratosis; erythematous plaques often progressing to erythroderma with islands of sparing; and waxy, palmoplantar keratoderma. The pathogenesis and etiology of PRP remain poorly understood. Small case series have shown dysregulation of the IL-23/IL-17 axis (Adnot-Desanlis et al., 2013; Feldmeyer et al., 2017; Nagai et al., 2020).