{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:10:08Z","timestamp":1756318208917,"version":"3.44.0"},"reference-count":28,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,22]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Pityriasis rubra pilaris (PRP) is a rare, inflammatory cutaneous disorder of unknown aetiology, and its association with inflammatory joint disease has not been well established. The lack of definitive evidence or clear guidelines makes PRP treatment difficult. Our patient presented with multiple large non-melanoma skin cancers (NMSCs) and a progressive cutaneous eruption consistent with PRP. NMSCs on presentation were found to be five basal cell carcinomas (BCCs), one squamous cell carcinoma and one invasive carcinoma with basaloid and squamous differentiation to skeletal muscle requiring radiation. His course was complicated by arthritis and reactive lymphadenopathy. Our patient saw slow improvement in his rash after treatment with ixekizumab and multiple Mohs surgeries for removal of his BCCs with decreased pruritus, erythema and hyperkeratosis. PRP-associated arthritis is a rare component of the primarily dermatologic disorder, and it is important for clinicians to be aware of this association to adequately address joint manifestations.<\/jats:p>","DOI":"10.1136\/bcr-2025-265660","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T05:32:27Z","timestamp":1749015147000},"page":"e265660","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pityriasis rubra pilaris with symmetric polyarthritis and lymphadenopathy"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7935-5232","authenticated-orcid":false,"given":"Isabella","family":"Anderson","sequence":"first","affiliation":[{"name":"Dermatology, University of Texas McGovern Medical School, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Boldt","sequence":"additional","affiliation":[{"name":"Internal Medicine, Baylor College of Medicine, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huong Amy","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen N","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"2025082710474745000_18.6.e265660.1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1177\/12034754231223159","article-title":"Updates on Pityriasis Rubra Pilaris: A Scoping Review","volume":"28","author":"Zhou","year":"2024","journal-title":"J Cutan Med Surg"},{"key":"2025082710474745000_18.6.e265660.2","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1001\/jamadermatol.2016.0091","article-title":"Epidemiologic, Clinicopathologic, Diagnostic, and Management Challenges of Pityriasis Rubra Pilaris: A Case Series of 100 Patients","volume":"152","author":"Ross","year":"2016","journal-title":"JAMA Dermatol"},{"key":"2025082710474745000_18.6.e265660.3","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/ced.13009","article-title":"Paraneoplastic pityriasis rubra pilaris: case report and literature review","volume":"42","author":"Bar-Ilan","year":"2017","journal-title":"Clin Exp Dermatol"},{"key":"2025082710474745000_18.6.e265660.4","first-page":"610","article-title":"Paraneoplastic pityriasis rubra pilaris as the presenting manifestation of metastatic squamous cell carcinoma","volume":"13","author":"Remedios","year":"2014","journal-title":"J Drugs Dermatol"},{"key":"2025082710474745000_18.6.e265660.5","first-page":"439","article-title":"Pityriasis rubra pilaris \u2013 a retrospective single center analysis over eight years","volume":"8","author":"Gemmeke","year":"2010","journal-title":"J Deutsche Derma Gesell"},{"key":"2025082710474745000_18.6.e265660.6","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1002\/jvc2.107","article-title":"The comprehensive impact of pityriasis rubra pilaris on physical symptoms, mental health, and activities of daily living: A mixed methods study","volume":"2","author":"Velasco","year":"2023","journal-title":"JEADV Clinical Practice"},{"key":"2025082710474745000_18.6.e265660.7","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1001\/jamadermatol.2020.3426","article-title":"Characterizing Disease Features and Other Medical Diagnoses in Patients With Pityriasis Rubra Pilaris","volume":"156","author":"Halper","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2025082710474745000_18.6.e265660.8","doi-asserted-by":"publisher","DOI":"10.2165\/11530070-000000000-00000"},{"key":"2025082710474745000_18.6.e265660.9","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1001\/jamadermatol.2020.0932","article-title":"Evaluation of Ixekizumab Treatment for Patients With Pityriasis Rubra Pilaris: A Single-Arm Trial","volume":"156","author":"Haynes","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2025082710474745000_18.6.e265660.10","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/bjd.21708","article-title":"Secukinumab for the treatment of adult-onset pityriasis rubra pilaris: a single-arm clinical trial with transcriptomic analysis","volume":"187","author":"Boudreaux","year":"2022","journal-title":"Br J Dermatol"},{"key":"2025082710474745000_18.6.e265660.11","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1001\/jamadermatol.2024.0257","article-title":"Guselkumab for Pityriasis Rubra Pilaris and Dysregulation of IL-23\/IL-17 and NFkB Signaling: A Nonrandomized Trial","volume":"160","author":"Velasco","year":"2024","journal-title":"JAMA Dermatol"},{"key":"2025082710474745000_18.6.e265660.12","article-title":"The Effectiveness of Anti-Interleukin-17A Treatment for Pityriasis Rubra Pilaris: A Systematic Review","volume":"15","author":"Abduljawad","year":"2023","journal-title":"Cureus"},{"key":"2025082710474745000_18.6.e265660.13","doi-asserted-by":"crossref","first-page":"e155","DOI":"10.1111\/j.1365-2230.2009.03747.x","article-title":"Rapid and sustained remission of pityriasis rubra pilaris with adalimumab treatment","volume":"35","author":"O\u2019Kane","year":"2010","journal-title":"Clin Exp Dermatol"},{"key":"2025082710474745000_18.6.e265660.14","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1111\/j.1365-2133.1996.tb07968.x","article-title":"Arthropathic pityriasis rubra pilaris","volume":"134","author":"Fiallo","year":"1996","journal-title":"Br J Dermatol"},{"key":"2025082710474745000_18.6.e265660.15","doi-asserted-by":"crossref","first-page":"e917","DOI":"10.1111\/j.1365-2230.2009.03701.x","article-title":"Pityriasis rubra pilaris in association with laryngeal carcinoma","volume":"34","author":"Batinac","year":"2009","journal-title":"Clin Exp Dermatol"},{"key":"2025082710474745000_18.6.e265660.16","first-page":"537","article-title":"Multiple basaliomas in pityriasis rubra pilaris","volume":"30","author":"Zabel","year":"1979","journal-title":"Hautarzt"},{"key":"2025082710474745000_18.6.e265660.17","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/RHU.0000000000002143","article-title":"Wong-Type Dermatomyositis: Literature Review of a Rare Variant","volume":"30","author":"Wanzenberg","year":"2024","journal-title":"J Clin Rheumatol"},{"key":"2025082710474745000_18.6.e265660.18","doi-asserted-by":"crossref","first-page":"e65","DOI":"10.1111\/pde.13030","article-title":"Follicular Psoriasis: Differentiation from Pityriasis Rubra Pilaris-An Illustrative Case and Review of the Literature","volume":"34","author":"Nguyen","year":"2017","journal-title":"Pediatr Dermatol"},{"key":"2025082710474745000_18.6.e265660.19","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.jaad.2012.09.018","article-title":"Pityriasis rubra pilaris with polyarthritis treated with adalimumab","volume":"68","author":"Chiu","year":"2013","journal-title":"J Am Acad Dermatol"},{"key":"2025082710474745000_18.6.e265660.20","doi-asserted-by":"crossref","unstructured":"Liu PY , Prete PE . Arthritis associated with pityriasis rubra pilaris. BMJ Case Rep 2010;2010. doi:10.1136\/bcr.12.2009.2565","DOI":"10.1136\/bcr.12.2009.2565"},{"key":"2025082710474745000_18.6.e265660.21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2007.02502.x"},{"key":"2025082710474745000_18.6.e265660.22","doi-asserted-by":"publisher","DOI":"10.1080\/10446670410001670008"},{"key":"2025082710474745000_18.6.e265660.23","doi-asserted-by":"publisher","DOI":"10.1159\/000065842"},{"key":"2025082710474745000_18.6.e265660.24","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1470.2002.00004.x"},{"key":"2025082710474745000_18.6.e265660.25","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199909)42:9<1998::AID-ANR28>3.0.CO;2-D"},{"key":"2025082710474745000_18.6.e265660.26","first-page":"318","article-title":"Pityriasis rubra pilaris and a seronegative polyarthritis","volume":"137","author":"Lister","year":"1997","journal-title":"Br J Dermatol"},{"key":"2025082710474745000_18.6.e265660.27","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.2214\/ajr.149.5.1082","article-title":"Acro-osteolysis secondary to pityriasis rubra pilaris","volume":"149","author":"Duke","year":"1987","journal-title":"AJR Am J Roentgenol"},{"key":"2025082710474745000_18.6.e265660.28","doi-asserted-by":"publisher","DOI":"10.1159\/000251995"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265660","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:47:54Z","timestamp":1756316874000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,4]]},"published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1136\/bcr-2025-265660"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265660","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}