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Picture of the Month

Gary L. Darmstadt, MD; Walter W. Tunnessen Jr, MD
Arch Pediatr Adolesc Med. 1995;149(8):923-924. doi:10.1001/archpedi.1995.02170210097018.
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A HEALTHY 8-year-old girl presented with a 6-week history of an acute, generalized skin eruption. Her palms and soles had become thickened and scaly over a 3-year period prior to eruption of the rash. Approximately 1 week before the eruption, she had mild pharyngitis. Over 1 to 2 days, erythema and scaling developed on her elbows, knees, scalp, and face. Over the following 1 to 2 weeks, the eruption spread over her upper and lower extremities and lastly over her trunk. The rash became increasingly hyperkeratotic and orangish-red in hue, and it covered 80% of her total body surface area (Figure 1 through Figure 4).

Editor's Note  There is no charge to authors for the publication of color pictures that appear in the Picture of the Month.Catherine D. DeAngelis, MD

Denouncement and Discussion 

Juvenile Pityriasis Rubra Pilaris  Pityriasis rubra pilaris (PRP) is an uncommon, chronic papulosquamous disorder of unknown cause.


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