Adult Onset versus Juvenile Onset


For most patients and caregivers, a diagnosis of pityriasis rubra pilaris results in a search of the internet. Dr. Google and Dr. Yahoo confirm that PRP is a rare skin disorder that may develop during childhood or adulthood. With great redundancy we are told the following:

✔︎ Adult onset accounts for 55% of the “active” PRP patient population while juvenile onset accounts for 45%. (1)

✔︎ Although PRP may occur at any age, it most commonly affects those in their first, second, fifth, and sixth decades of life. (2)(3)

METHODOLOGY

To explain his methodology for calculating the prevalence rate of pityriasis rubra pilaris, Griffiths writes: “Most dermatologists never have a new case of PRP although they may see one at a meeting, so it is clear that PRP is a very rare disorder. We estimated, very roughly, a prevalence rate of … one case per 400,000 of the population. This would mean that there are around 150 cases in the UK at any one time. Assuming there are approximately 600 dermatologists in the UK, that means just under one in four dermatologists may be currently looking after a case. (At this point a show of hands of how many people were currently looking after a case of PRP was approximately 1 in 5).”

PRP GLOBAL DATABASE

Based on 1,424 patient profiles where the onset age was confirmed, the prevalence of juvenile onset was less than half of Dr. Griffiths’ projections.
✔︎ Less than 17 years old: 276 (21.4%)
✔︎ 18 years and older: 1,148 (80.6%)

REFERENCES

(1) DermNet New Zealand. Pityriasis rubra pilaris. www.dermnetnz.org/topics/pityriasis-rubra-pilaris/ Updated October, 2015. Accessed August 7, 2017.
(2) Judge MR, McLean WHI, Munro CS. Disorders of keratinization. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook’s textbook of dermatology. 8th ed. Oxford: Blackwell Publishing Ltd; 2010. p. 19.1-19.122.(3) Paravina M, Ljubenovic M, Milosavljevic M, et.al. Pityriasis rubra pilaris: A report of two cases and literature review. https://www.degruyter.com/downloadpdf/j/sjdv.2015.7.issue-4/sjdv-2015-0016/sjdv-2015-0016.pdf. Serbian J Dermatol Venereol. 2015; 7 (4): 181-194 DOI: 10.1515/sjdv-2015-0016. Accessed August 7, 2017.