Pityriasis rubra pilaris with preceding cytomegalovirus infection

Pityriasis rubra pilaris (PRP) is a papulosquamous disorder comprising 6 clinical types. Some factors - including abnormal vitamin A metabolism, internal malignancies, autoimmune diseases, infection and trauma - are thought to be involved in the etiology. Recently, human immunodeficiency virus (HIV)-associated PRP has been reported to have distinct clinical features, such as nodulocystic acne and lichen spinulosus alongside PRP. We report here the case of a 38-year-old female with onset of classical PRP after a high fever. Virological studies indicated that the patient had primary systemic cytomegalovirus (CMV) infection and not HIV infection. Our case suggested that primary CMV infection might have triggered typical PRP that was clinically different from HIV-associated PRP.