Keratosis Pilaris Rubra Totalis: Clinical and Histopathological Study with New insights


Keratosis Pilaris Rubra Totalis: Clinical and Histopathological Study with New insights


1Professor Khalifa E. Sharquie MD; PhD; 1Professor Adil A. Noaimi MD; FICMS.; 2Dr. Raed I. Jabbar MD; CABD.

1Department of Dermatology, College of Medicine, University of Baghdad. Iraqi and Arab Board of Dermatology and Venereology, Center of Dermatology and Venereology, Medical City, Baghdad, Iraq.2Center of Dermatology and Venereology, Medical City, Baghdad, Iraq


Background: Keratosis pilaris rubra (KPR) is a common but unrecognized follicular keratinizatioin. It is a common skin problem among Iraqi population and most cases were misdiagnosed as dermatitis as there are few reports in medical literature.

Objective: To do full clinical and histopathological evaluation of  KPR in Iraqi population.

Patients and Methods: This is case descriptive, clinico-histopathological outpatient based study. It was done in the Center of Dermatology and Venereology, Baghdad Teaching Hospital, Medical City, Iraq during the period from March 2016 to October 2017. Sixty patients were enrolled in this study. History and dermatological examination were carried out for all patients. Skin biopsy was done for 10 patients for histopathological study using Hematoxylin and Eosin stain.

Results: A total of the 60 patients were diagnosed as KPR during the study period. Thirty nine (65%) males and 21 (35%) females. The age at onset of disease ranged from since birth to 8 (2.9± 2.17) years . Facial involvement included the cheeks in 60 (100%) patients. Other sites of involvement included the arms where the lateral aspects involved in 60 (100%) patients and the medial aspect 11 (18.3%), thighs including the buttocks in 51 (85%), trunk 25 (41.6%), legs 22 (36.6%) and the neck 15 (25%).The rash was erythematous all over but most obvious on the sides of face presenting as red, rough face. Histopathological evaluation showed follicular plugging in (100%) with dilatation of both superficial and deep vascular plexus in (75%) of cases.

Limitation: The main limitation of this study was the lack of follow up data related to the subject of the study.

Conclusion: KPR is a common condition among Iraqi population and this study is the largest study carried out all over the world. As most areas of body are involved, the name keratosis pilaris rubra totalis is suggested.


Keywords: Keratosis pilaris rubra, follicular papules, red face.


Free Full-text PDF


How to cite this article:
Khalifa E. Sharquie, Adil A. Noaimi, Raed I. Jabbar. Keratosis Pilaris Rubra Totalis: Clinical and Histopathological Study with New insights. American Journal of Dermatological Research and Reviews, 2020, 3:25. DOI: 10.28933/ajodrr-2020-03-1005


References:

1. Thomas M, Khopkar US. Keratosis pilaris revisited: is it more than just a follicular keratosis? Int J Trichol 2012; 4:255–8.
2. Hwang S, Schwartz RA. Keratosis pilaris: a common follicular hyperkeratosis. Cutis 2008; 82:177–80.
3. Chu AC, Teixeira F. Acquired Disorders of Epidermal Keratinization. In: Griffiths C, Barker J, Bleiker T, Chalmers R, Creamer D,eds.Rook′s Textbook of Dermatology, 9th ed. Singapore, Blackwell Science,2016;87:8-14.
4. Mirmirani P, Rogers M. Keratosis Pilaris and Other Inflammatory Follicular Keratotic Syndromes. In: Goldsmith LA, Kataz SI, Gilchrest BA, Paller SA, Leffell DJ, Wolf K, editors. Fitzpatrick’s Dermatology in General Medicine, 8th ed. New York, McGrow Hill, 2012; 15, 87:973-974.
5. Marqueling AL, Gilliam AE, Prendiville J, Zvulunov A, Antaya RJ, Sugarman J ,et al.Keratosis pilaris rubra: a common but unrecognized condition. Arch Dermatol 2006; 142:1611–1616.
6. Bukhari I A, Al Ghamdi N, Al Zahrani A, Al Shawarby M. Generalized keratosis pilaris rubra. Our Dermatol Online.2015; 6:187-189.
7. Schoch JJ, Tollefon MM, Witman P, Davis DM. Successful Treatment of Keratosis Pilaris Rubra with Pulsed Dye Laser. Pediatr Dermatol.2016.jul;33:443-6.
8. Weedon D. Disease of cutaneous appendages. In: Weedon′s skin pathology, 3rd ed. Edinburgh , Churchil Livi ngstone ,2010;4,15:432-433.