Refractory pityriasis rubra pilaris treated with upadacitinib

Pityriasis rubra pilaris (PRP) is a rare idiopathic inflammatory skin disorder with a classic clinical presentation of follicular hyperkeratotic papules that coalesce into generalized salmon-colored plaques.1 PRP is classified into 6 subtypes, with type I (classical adult onset) being the most common at 55% of cases.1 Treatment for type I PRP has traditionally involved topical emollients, corticosteroids, and retinoids along with systemic therapies such as methotrexate, cyclosporine, and azathioprine.