{"title":"Pityriasis Rubra Pilaris and underlying malignancy.","authors":"Wang Lin, Wenting Xu, Cheng Tan","doi":"10.1093/qjmed/hcae192","DOIUrl":null,"url":null,"abstract":"<p><p>A 59-year-old man presented with a five-month history of widespread, salmon-colored, scaly plaques. Skin examination revealed salmon-colored plaques with \"islands of sparing\" on the trunk and waxy keratoderma on the palms and soles. Histopathology of the lesion showed alternating orthokeratosis and parakeratosis in vertical and horizontal directions, consistent with a diagnosis of pityriasis rubra pilaris (PRP). The patient was unresponsive to methotrexate and Secukinumab. Further evaluation through a computerized tomography scan revealed a presence of air-filled multicystic changes in the upper left lung, accompanied by diffuse pulmonary bullae. Elevated serum tumor markers, including CEA, NSE, and SCC, indicated an underlying acinar-predominant adenocarcinoma, suggesting a paraneoplastic PRP. He was subsequently referred to the oncology department for further management. This report underscores the importance of identifying an underlying malignancy in recalcitrant PRP cases.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":7.3000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"QJM: An International Journal of Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/qjmed/hcae192","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
A 59-year-old man presented with a five-month history of widespread, salmon-colored, scaly plaques. Skin examination revealed salmon-colored plaques with "islands of sparing" on the trunk and waxy keratoderma on the palms and soles. Histopathology of the lesion showed alternating orthokeratosis and parakeratosis in vertical and horizontal directions, consistent with a diagnosis of pityriasis rubra pilaris (PRP). The patient was unresponsive to methotrexate and Secukinumab. Further evaluation through a computerized tomography scan revealed a presence of air-filled multicystic changes in the upper left lung, accompanied by diffuse pulmonary bullae. Elevated serum tumor markers, including CEA, NSE, and SCC, indicated an underlying acinar-predominant adenocarcinoma, suggesting a paraneoplastic PRP. He was subsequently referred to the oncology department for further management. This report underscores the importance of identifying an underlying malignancy in recalcitrant PRP cases.
期刊介绍：
QJM, a renowned and reputable general medical journal, has been a prominent source of knowledge in the field of internal medicine. With a steadfast commitment to advancing medical science and practice, it features a selection of rigorously reviewed articles.
Released on a monthly basis, QJM encompasses a wide range of article types. These include original papers that contribute innovative research, editorials that offer expert opinions, and reviews that provide comprehensive analyses of specific topics. The journal also presents commentary papers aimed at initiating discussions on controversial subjects and allocates a dedicated section for reader correspondence.
In summary, QJM's reputable standing stems from its enduring presence in the medical community, consistent publication schedule, and diverse range of content designed to inform and engage readers.
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