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Diseases

Genetic and Rare Diseases Information Center (GARD)

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Pityriasis rubra pilaris


Other Names for this Disease

  • Familial pityriasis rubra pilaris
  • Pityriasis rubra pilaris--familial type
  • PRP
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Your Question

What treatment can I use for PRP? Is there a connection between PRP and vitamin A? It seems my condition gets worse every time I eat any veggies or fruits containing a high concentration of vitamin A.

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

How might pityriasis rubra pilaris be treated?

Treatment of pityriasis rubra pilaris (PRP) is mainly based on reports of patients' experiences. No controlled trials have been done, so the effectiveness and safety of treatments is unclear. Currently there are no treatments approved by the US Food and Drug Administration (FDA) or the European Medicines Agency (EMA) for use in PRP.[1]

Management of PRP often involves systemic and topical therapies combined. Topical therapies can help with the symptoms and may be enough for people with mild PRP. Topical treatments are usually combined with systemic therapy for PRP that affects a large part of the body. Most people need systemic therapy to control the condition.[1]

Oral retinoids (synthetic vitamin A derivatives) are usually preferred as a first-line systemic treatment for PRP. Methotrexate may be an alternative option for people who should not use systemic retinoids, or who don't respond to systemic retinoid therapy. For people who don't respond well to retinoid or methotrexate therapy, options may include biologic TNF-alpha inhibitors, azathioprine, cyclosporine, and/or phototherapy. Topical treatments used for PRP may include topical corticosteroids, keratolytics, tar, calcipotriol, topical tretinoin, and tazarotene.[1]

Some of the medications used to treat PRP can harm a developing fetus and are not recommended for use right before or during pregnancy.[1] People seeking information about specific treatment options for themselves or family members should speak with their health care provider.
Last updated: 3/10/2014

Is vitamin A intake known to worsen the symptoms of pityriasis rubra pilaris?

We are not aware of any published reports that eating foods high in vitamin A worsens the symptoms of pityriasis rubra pilaris (PRP). On the contrary, vitamin A, as well as synthetic vitamin A derivatives, are sometimes used to treat this condition and attempt to improve the symptoms of PRP. However, response to these treatments varies among affected people.[1]

Abnormal vitamin A metabolism was once proposed as a possible factor contributing to the development of PRP. Early theories proposed that vitamin A deficiency might play a role in causing the condition. However, further studies did not confirm these theories. Whether abnormal vitamin A metabolism is associated with PRP remains unclear.[1]
Last updated: 3/10/2014

References
  • Andreas Katsambas and Clio Dessinioti. Pityriasis rubra pilaris. UpToDate. Waltham, MA: UpToDate; March, 2014; Accessed 3/10/2014.
Other Names for this Disease
  • Familial pityriasis rubra pilaris
  • Pityriasis rubra pilaris--familial type
  • PRP
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.