Pityriasis Rubra Pilaris Presenting with Hyperkeratotic Soles: An Uncommon Case Report

Pityriasis rubra pilaris is a rare, chronic, papulosquamous skin disorder characterized by follicular hyperkeratosis, erythematous scaling plaques, and palmoplantar keratoderma. The disease often presents with a distinct orange-red coloration of the skin and islands of sparing within areas of widespread erythema. Although the exact pathogenesis is unknown, associations with genetic mutations, autoimmune conditions, and abnormal keratinization have been proposed. We report the case of a 9-year-old female child admitted to the Government General Hospital, Kadapa, with progressive thickening of the skin over both soles, associated with fissuring for the past two years, and pruritus. The patient also reported multiple raised small lesions over both arms for the past seven months. Her past medical history revealed symptom aggravation while walking barefoot, with no history of trauma or drug intake. This case highlights the importance of recognizing pityriasis rubra pilaris in clinical practice.