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Pityriasis rubra pilaris: A clinico-pathological and therapeutic study with special reference to histochemistry, autoradiography, and electron microscopy


Five patients with pityriasis rubra pilaris (PRP) were analyzed by means of light and electron microscopy as well as by histochemistry and autoradiography. The results were compared with findings in psoriasis vulgaris. In PRP we found a moderate increase of the labeling index of epidermal cells, a highly increased labeling index of dermal infiltrating cells, and a mild spongiosis, and in the stratum granulosum, a decreased number of tonofilaments and an increased number of keratinosomes. The horny layer in PRP showed a pronounced histochemical and electron microscopical parakeratosis, even when histological parakeratosis was absent. In contrast with psoriasis vulgaris, there was no exocytosis of polymorphonuclear leucocytes into the epidermis, the papillomatosis index was normal, and there were no tortuous capillaries in the dermal papillae. The stratum granulosum was always present and sometimes thickened, showing electron microscopical changes different from those referred to in psoriasis. These changes point to a relatively distinct pattern of epidermal changes in PRP.

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  1. 1.

    Ackermann AB (1978) Histologic diagnosis of inflammatory skin diseases. Lea and Febinger, Philadelphia

  2. 2.

    Anton-Lamprecht I (1972) Zur Ultrastruktur hereditärer Verhornungsstörungen. I. Ichthyosis congenita. Arch Dermatol Forsch 243:88–100

  3. 3.

    Anton-Lamprecht I (1981) Disturbances of tonofilament and keratohyaline structure and arrangement in inborn errors of keratinization. In: Marks R, Christophers E (eds) The epidermis in disease. MTP Press Limited, Falcon House, Lancaster, England

  4. 4.

    Braun-Falco O (1958) The histochemistry of psoriasis. Ann NY Acad Sci 73:936–976

  5. 5.

    Braun-Falco O (1963) Zur Morphogenese der psoriatischen Hautreaktion. Arch Klin Exp Dermatol 216:130–154

  6. 6.

    Braun-Falco O (1971) Dynamics of growth and regression in psoriatic lesions: Alterations in the skin from normal into a psoriatic lesion and during regression of psoriatic lesions. In: Farber EM, Cox AJ (eds) Psoriasis. Proceedings of the Int. Symposium, Stanford University. Stanford University Press, pp 215–237

  7. 7.

    Braverman IM, Yen A (1977) Ultrastructure of the capillary loops in the dermal papillae of psoriasis. J Invest Dermatol 68:53–60

  8. 8.

    Brody I, Mishima Y, Matsunaka M (1974) Stratum corneum in psoriasis vulgaris. A transmission and scanning electron microscopic study. J Cut Pathol 1:33–46

  9. 9.

    Christophers E, Braun-Falco O (1970) Mechanisms of parakeratosis. Br J Dermatol 82:268–275

  10. 10.

    Finzi AF, Altomare G, Bergamaschini L, Tucci A (1981) Pityriasis rubra pilaris and retinol-binding protein. Br J Dermatol 104:253–256

  11. 11.

    Gordon M, Johnson WC (1967) Histopathology and histochemistry of psoriasis. Arch Dermatol 95:402–407

  12. 12.

    Griffiths WAD (1980) Pityriasis rubra pilaris. Clin Exp Derm 5:105–112

  13. 13.

    Griffiths WAD, Pieris S (1982) Pityriasis rubra pilaris — an autoradiographic study. Br J Dermatol 107:665–667

  14. 14.

    Hofmann C, Landthaler M, Plewig G, Braun-Falco O (1980) In vivo autoradiography and planimetry of epidermis in psoriatics under PUVA-therapy. Arch Dermatol Res 267:61–70

  15. 15.

    Landthaler M, Plewig G, Hofmann C, Braun-Falco O (1980) Autoradiographic and planimetric analyses of the inflammatory infiltrate in psoriatic lesions under PUVA-therapy. Arch Dermatol Res 269:31–37

  16. 16.

    Marks R, Griffiths A (1973) The epidermis in pityriasis rubra pilaris: A comparison with psoriasis. Br J Dermatol [Suppl 9] 89:19–20

  17. 17.

    Marks R, Finlay S, Nicholls S, Barton S (1981) The effects of retinoids on the stratum corneum structure and function. In: Orfanos CE (ed) Retinoids. Springer, Berlin Heidelberg New York, pp 77–83

  18. 18.

    Metz J, Metz G (1975) Zur Ultrastruktur der Epidermis bei seborrhoischem Ekzem. Arch Dermatol Forsch 252:285–269

  19. 19.

    Niemi KM, Kousa M, Storgards K, Karvonen J (1976) Pityriasis rubra pilaris. Dermatologica 152:109–118

  20. 20.

    Orfanos CE (1972) Feinstrukturelle Morphologie und Histopathologie der verhornenden Epidermis. Thieme, Stuttgart

  21. 21.

    Orfanos CE (1981) Aufbau der Hornschicht in Hinblick auf ihre Funktion. In: Klaschka F (ed) Stratum corneum. Struktur und Funktion. Grosse, Berlin, pp 29–47

  22. 22.

    Ralfs IG, Dawber RPR, Ryan TJ, Wright NA (1981) Pityriasis rubra pilaris: Epidermal cell kinetics. Br J Dermatol 104:249–252

  23. 23.

    Unna PG (1894) Die Histopathologie der Hautkrankheiten. Hirschwald, Berlin

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Correspondence to O. Braun-Falco.

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Braun-Falco, O., Ryckmanns, F., Schmoeckel, C. et al. Pityriasis rubra pilaris: A clinico-pathological and therapeutic study with special reference to histochemistry, autoradiography, and electron microscopy. Arch Dermatol Res 275, 287–295 (1983). https://doi.org/10.1007/BF00417199

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Key words

  • Pityriasis rubra pilaris
  • Histochemistry
  • Autoradiography
  • Electron microscopy