PRP with subcorneal acantholysis: case report and review

Area of Science:

• Dermatopathology
• Histopathology
• Clinical Dermatology

Background:

• Pityriasis rubra pilaris (PRP) presents with distinct clinical features but can pose diagnostic challenges histopathologically.
• Microscopic examination of PRP biopsies may show subtle changes that overlap with other dermatoses.
• Distinguishing PRP from other conditions like pemphigus is crucial for appropriate patient management.

Observation:

• A patient with Pityriasis rubra pilaris (PRP) underwent initial skin biopsies.
• The initial histopathological evaluation revealed subcorneal acantholysis.
• This finding mimicked the microscopic features of pemphigus foliaceus.

Findings:

• The case demonstrates that Pityriasis rubra pilaris can exhibit subcorneal acantholysis.
• This specific histopathological finding can lead to misdiagnosis, resembling pemphigus foliaceus.
• The subtle nature of PRP's microscopic changes underscores the importance of correlating histopathology with clinical presentation.

Implications:

• Accurate histopathological diagnosis of Pityriasis rubra pilaris is essential for effective treatment.
• Awareness of atypical microscopic presentations, such as subcorneal acantholysis, is critical for dermatopathologists.
• This case emphasizes the need for careful clinicopathological correlation in diagnosing challenging dermatological conditions.