{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T17:29:11Z","timestamp":1789752551982,"version":"4.0.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pityriasis rubra pilaris is a chronic, scaly, keratotic skin disease, mainly manifested as scaly plaques and keratinized hair follicles. This condition significantly impacts the patient\u2019s quality of life and is considered one of the intractable diseases in dermatology. Currently, no satisfactory clinical treatment options are available for this condition, presenting a considerable challenge for dermatologists. We conducted this systematic evaluation to assess the therapeutic potential of existing small molecule drugs for this disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To conduct a systematic review of the existing literature on the use of small molecule drugs for treating pityriasis rubra pilaris and to evaluate their clinical effectiveness and safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review of all the literature on small molecule drugs for the treatment of Pityriasis rubra pilaris and searched several databases until November 2024, including PubMed, Embase, Web of Science, and the Cochrane Library.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 16 patients with pityriasis rubra pilaris from 11 publications were included. The small molecule drugs, including apremilast, upadacitinib, abrocitinib, and tofacitinib, demonstrate good efficacy and safety in the treatment of pityriasis rubra pilaris across all ages, particularly in patients who have failed systemic therapy and have a poor response to biological agents. However, the conclusions are limited by the small sample size and need to be further confirmed through large-scale randomized controlled clinical trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Small molecule drugs demonstrate favorable clinical efficacy and safety in the treatment of refractory pityriasis rubra pilaris, exhibiting a relatively rapid onset and a high safety profile. However, the findings in the literature may be affected by publication bias.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1544197","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T11:36:22Z","timestamp":1740483382000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris\u2014A systematic review"],"prefix":"10.3389","volume":"12","author":[{"given":"Xiaofang","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kebo","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxia","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yugu","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.09.056","article-title":"Pityriasis rubra pilaris.","author":"Sagut","year":"2024","journal-title":"J Am Acad Dermatol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s40257-023-00836-x","article-title":"Pityriasis rubra pilaris: An updated review of clinical presentation, etiopathogenesis, and treatment options.","volume":"25","author":"Joshi","year":"2024","journal-title":"Am J Clin Dermatol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1046\/j.1365-2133.1996.d01-1114.x","article-title":"Pityriasis rubra pilaris and human immunodeficiency virus infection\u2013type 6 pityriasis rubra pilaris?","volume":"135","author":"Misery","year":"1996","journal-title":"Br J Dermatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"100","DOI":"10.4103\/ijstd.IJSTD_120_15","article-title":"Pityriasis rubra pilaris type 6: A case report in an AIDS patient.","volume":"41","author":"Williams","year":"2020","journal-title":"Indian J Sex Transmitted Dis AIDS."},{"key":"B5","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jdcr.2022.07.015","article-title":"Pityriasis rubra pilaris rapidly cleared with ixekizumab in an HIV-positive patient.","volume":"27","author":"Kranyak","year":"2022","journal-title":"JAAD Case Rep."},{"key":"B6","doi-asserted-by":"publisher","first-page":"522","DOI":"10.4103\/ijd.IJD_141_18","article-title":"Atypical adult-onset Pityriasis rubra pilaris in an HIV-positive adult male.","volume":"63","author":"Nair","year":"2018","journal-title":"Indian J Dermatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1016\/j.ad.2021.01.006","article-title":"Facial discoid dermatosis: A new variant of Pityriasis rubra pilaris?","volume":"113","author":"Allegue","year":"2022","journal-title":"Actas Dermosifiliogr."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1111\/bjd.21792","article-title":"Patient and disease characteristics associated with psychiatric symptoms and impaired quality of life in Pityriasis rubra pilaris.","volume":"187","author":"Ji-Xu","year":"2022","journal-title":"Br J Dermatol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.jdcr.2022.12.007","article-title":"Rethinking Pityriasis rubra pilaris as a paraneoplastic syndrome: Two cases of pityriasis rubra pilaris with concomitant underlying malignancy.","volume":"32","author":"Davis","year":"2023","journal-title":"JAAD Case Rep."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e26","DOI":"10.1111\/jdv.18556","article-title":"COVID-19 induced Pityriasis rubra pilaris: A superantigenic disease?","volume":"37","author":"Aromolo","year":"2023","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19046","article-title":"Clinical characteristics of patients with Pityriasis rubra pilaris following SARS-CoV-2 vaccination.","author":"Gambichler","year":"2023","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"B12","first-page":"221","article-title":"[Acute Pityriasis rubra pilaris in the child. 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