Pityriasis Rubra Pilar with Preceeding Herpes Infection in Childhood - Successful Treatment with Methotrexate

The Pityriasis rubra pilaris (PRP) is a rare, inflammatory, chronic disease of unknown etiology characterized by follicular papules, pinkish-yellow squamous plaques and palmoplantar keratoderma. The clinical diagnosis is very important and is confirmed by biopsy of the skin. Often, the clinical presentation can be confused with other diagnosis such as psoriasis and atopic dermatitis. Currently, the first-line therapy is the systemic retinoid and other treatments like methotrexate. The association with viral disease is uncommon. Our purpose is to report a case of PRP in a young boy associated with a prior primo-infection by herpes simplex showing a favorable response to oral treatment with methotrexate and without recurrence after 10 months of follow-up.

Keywords: Herpes infection, Methotrexate, Pityriasis rubra pilaris.