title: Therapeutic hotline. Treatment of pityriasis rubra pilaris with etanercept.
abstract: Pityriasis rubra pilaris (PRP) or Devergie's disease is a chronic and rare papulosquamous disorder of unknown etiology characterized by reddish orange scaly plaques, palmoplantar keratoderma, and keratotic follicular papules. The present authors report a case of a 30-year-old woman with clinical and histologic signs of PRP (type I adult onset, Griffith's classification). After a few unsuccessful treatments, the present authors chose to start etanercept. Total clearing of the lesions was achieved 5 months after starting the drug. Etanercept is a TNF-α inhibitor, and today it is largely used in the treatment of several dermatological diseases through blockage of the inflammatory cytokine. The true mechanism of action in PRP remains to be explained; however, the favorable results in our case raise new questions about TNF-α's role in PRP and suggest a therapeutic alternative for resistant cases to classic treatments. To date, there are only three case reports of PRP treated with etanercept in the literature.
authors.affiliation: Dermatology Department, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia Dermatology Department-Clínica Laser Belém, Lisbon, Portugal. ritapereiraguedes@gmail.com
authors.forename: Rita
authors.initials: R
authors.lastname: Guedes
authors.forename: Luiz
authors.initials: L
authors.lastname: Leite
mesh_terms: D000328:Adult; D001706:Biopsy; D003879:Dermatologic Agents / Q000627:therapeutic use*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D010916:Pityriasis Rubra Pilaris / Q000175:diagnosis / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept