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A Common but Underrecognized Condition

Ann L. Marqueling, MD; Amy E. Gilliam, MD; Julie Prendiville, MD; Alex Zvulunov, MD; Richard J. Antaya, MD; Jeffrey Sugarman, MD, PhD; Mei-Lin Pang, MD; Phillip Lee, MD; Lawrence Eichenfield, MD; Brandie Metz, MD; Gerald N. Goldberg, MD; Roderic J. Phillips, MD; Ilona J. Frieden, MD

Arch Dermatol. 2006;142:1611-1616.

Background  Keratosis pilaris is a common skin disorder of childhood that often improves with age. Less common variants of keratosis pilaris include keratosis pilaris atrophicans and atrophodermia vermiculata.

Observations  In this case series from dermatology practices in the United States, Canada, Israel, and Australia, the clinical characteristics of 27 patients with keratosis pilaris rubra are described. Marked erythema with follicular prominence was noted in all patients, most commonly affecting the lateral aspects of the cheeks and the proximal arms and legs, with both more marked erythema and widespread extent of disease than in keratosis pilaris. The mean age at onset was 5 years (range, birth to 12 years). Sixty-three percent of patients were male. No patients had atrophy or scarring from their lesions. Various treatments were used, with minimal or no improvement in most cases.

Conclusions  Keratosis pilaris rubra is a variant of keratosis pilaris, with more prominent erythema and with more widespread areas of skin involvement in some cases, but without the atrophy or hyperpigmentation noted in certain keratosis pilaris variants. It seems to be a relatively common but uncommonly reported condition.

Author Affiliations: Departments of Dermatology, University of California, San Francisco (Drs Marqueling, Gilliam, Sugarman, and Frieden), San Diego (Drs Pang, Lee, Eichenfield, and Metz), and Irvine (Dr Metz); University of British Columbia, Vancouver (Dr Prendiville), and Yale University, New Haven, Conn (Dr Antaya); Department of Pediatric Dermatology, Schneider Children's Medical Center, New Hyde Park, NY (Dr Zvulunov); Department of Pediatrics, Royal Children's Hospital, Parkville, Victoria, Australia (Dr Phillips); and Pima Dermatology, Tucson, Ariz (Dr Goldberg).

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