Pityriasis rubra pilaris pathology

Figure 3

Histology of pityriasis rubra pilaris

In PRP, the epidermis shows regular acanthosis and psoriasiform hyperplasia (figures 1-3). The horn is thickened with parakeratotic foci between orthokeratosis both vertically and horizontally (not seen clearly in the presented images). The hyperkeratosis tracks down the openings of follicular structures forming follicular plugs (figures 1-3). The dermis may contain a mixed sparse infiltrate which may be lichenoid. Rarely, foci of acantholysis may be seen (figure 3) and some authors have made associations with Darier disease.

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Source: dermnetnz.org