title: Ineffectiveness of tumor necrosis factor-α blockers and ustekinumab in a case of type IV pityriasis rubra pilaris.
abstract: Treatment of pityriasis rubra pilaris (PRP) may be difficult since no standardized therapeutic approach has been established. Recently, tumor necrosis factor-α (TNF-α) blockers have been demonstrated to be favorable in the management of recalcitrant PRP. The authors report a case of a patient who presented a type IV PRP or circumscribed, juvenile type. Such a condition follows an unpredictable course, presenting with diffuse, palmoplantar keratoderma and sharply-demarcated areas of follicular hyperkeratosis on the elbows and knees. Treatment with all available TNF-α inhibitors and ustekinumab did not prove to be helpful. The authors suggest that circumscribed variants of PRP could respond to therapy in ways different from classical PRP.
authors.affiliation: Department of Internal Medicine and Medical Specialities, Dermatology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: Vito Di
authors.initials: VD
authors.lastname: Lernia
authors.affiliation: Department of Internal Medicine and Medical Specialities, Dermatology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Ficarelli
authors.affiliation: Department of Internal Medicine and Medical Specialities, Pathology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
authors.forename: Magda
authors.initials: M
authors.lastname: Zanelli
keywords: Pityriasis rubra pilaris; treatment; tumour necrosis factor; ustekinumab