Saw a Patient W/ Severe Keratosis Pilaris - Any Systemic Treatment Options?

187502 · Oct 27, 2008

I saw a 24 y/o white male yesterday for a case of bronchitis and I noticed that he had the most severe keratosis pilaris rubra I (as well as my resident) had ever seen. It literally went from his ankles to his collar without stopping.

When I asked him about it he said all manner of topical treatment in the past had failed to produce reasonable results. He asked us if there were any systemic treatment that have developed since his failure with topical treatments. I said I didn't know but would look into it and get back to him. I looked through several resources and didn't find any discussion of systemic treatments. Are any systemic treatment available on an off-label basis at this time?

Mariah246 · Oct 27, 2008

Is that KP? I've seen KP localized to the lateral arms. Never in the distribution you mentioned.

(Of course, I have 2 weeks experience on this topic.)

Ignite hardcore · Nov 2, 2008

BoxTortoise said:
I saw a 24 y/o white male yesterday for a case of bronchitis and I noticed that he had the most severe keratosis pilaris rubra I (as well as my resident) had ever seen. It literally went from his ankles to his collar without stopping.

When I asked him about it he said all manner of topical treatment in the past had failed to produce reasonable results. He asked us if there were any systemic treatment that have developed since his failure with topical treatments. I said I didn't know but would look into it and get back to him. I looked through several resources and didn't find any discussion of systemic treatments. Are any systemic treatment available on an off-label basis at this time?

Not sure if you mean pityriasis rubra pilaris? I have never heard of erythroderma secondary to severe keratosis pilaris. Possible keratosis pilaris in association with ichthyosis vulgaris in a severe case would merit systemic therapy...

As far as systemic treatments for PRP, I believe weekly methotrexate and psoriatane is a common regimen when either alone does not cause improvement. Biologicals have also been used.

187502 · Nov 6, 2008

Ignite hardcore said:
Not sure if you mean pityriasis rubra pilaris? I have never heard of erythroderma secondary to severe keratosis pilaris. Possible keratosis pilaris in association with ichthyosis vulgaris in a severe case would merit systemic therapy...

I'm asking about keratosis pilaris rubra, you can check out a summary of the condition here:

http://archderm.ama-assn.org/cgi/content/abstract/142/12/1611

Looks like this is a dead forum though. I'll just tell him I didn't find anything.

vkrn · Nov 17, 2008

BoxTortoise, I have to say, your last comment was really remarkable.

You come to SDN, not to board-certified dermatologists, to ask for treatment options for a skin condition...

You don't provide pictures or any detailed clinical history about this supposed keratosis pilaris...

You don't demonstrate that you've done any of your own journal-based or other scientific research...

Based on this quite limited effort, you state that you'll report back to A PATIENT WHOM YOU'RE HELPING TO CARE FOR to say you didn't find any new systemic therapeutics for him. Which he'll likely interpret as there being definitely no systemic therapeutics for him.

And then you blame SDN's derm forum.

Nice.

Saw a Patient W/ Severe Keratosis Pilaris - Any Systemic Treatment Options?

187502

Mariah246

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Ignite hardcore

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187502

vkrn

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