What are the symptoms of PRP?

When a dermatologist examines a patient who will eventually be diagnosed with PRP, they may see signs and symptoms that suggest a more common skin disorder. When that dermatologist combines medical training, clinical observations and biopsies and makes a diagnosis of psoriasis or atopic dermatitis, it is called a differential diagnosis — not a mistake. A differential diagnosis is how the medical community defines a diagnosis other than the one that is finally established.

The 2014 PRP Worldwide Census identified onset symptoms reported by 477 PRP patients. The range of symptoms — and where they appear — underscores how each case of PRP is as unique as a snowflake. For example:

Words used by PRP patients to describe the onset symptoms

✽  A total of 294 PRP patients used the term rash (201), spot (97) or blemish (19)

✽  A total of 70 used the term itchy, and 57 used patches, shedding, dandruff, bumps, sunburn and peeling.

Words used by PRP patients to describe location of symptoms

✽  Head (168) which includes: scalp, face, forehead, head, eyes, ears and nose

✽  Upper torso (86) which includes chest, back (36), shoulder and torso

✽  Upper extremities (66): hands, arms and fingers

✽  Lower extremities (38): feet and legs

Looking for more symptoms…

Sometimes a PRP patient or caregiver want to compare their version of PRP with others who share this über-rare skin disorder. A search of the internet offers a glimpse of the range of signs and symptoms that are consistent with pityriasis rubra pilaris and a wide range of other possible diagnoses.

Here is a sampling of the signs and symptoms that apply to PRP.


❐     Onset of symptoms vary greatly between affected individuals

❐     Onset can be gradual or more rapid

❐     Redness and scaling of the face and scalp are often seen first, followed by redness and thickening of the palms and soles.

❐     Overall, the elbows, knees, backs of the hands and feet, and ankles are most commonly affected..

❐     Lesions may expand and coalesce and eventually cover the entire body.


❐     Color: pink, red or red-orange

❐     Itching

❐     Elbows, knees, hands and/or ankles

❐     Often there is a solitary lesion but within a few weeks multiple patches appear and they join together to form groups of reddish-orange lesions. Over a few weeks these spread downwards and may cover most of the body (erythroderma).


❐     skin lesions described as “sharply pointed, horn-like, brownish-red to rosy yellow- colored”


Note: a small, raised, solid pimple or swelling, often forming part of a rash on the skin and typically inflamed but not producing pus.

❐     Occur on the back of the wrists, the outside of the forearms, underarm folds, elbows, knees, backs of the hands, and/or fingers?

❐     Grow and connect together they produce dry, scaly, rough, red plaques over large areas of the skin.


❐     Red scaly rash on head, neck and upper trunk as a red scaly rash.


❐     Gray, brittle nails

❐     Thickened and discolored at the free nail edge and may show linear black streaks (splinter hemorrhages).


❐     On the scalp (seborrhea)

❐     On face


❐     Edges of the eyelids are turned outward (ectropion).


❐     Skin has become red and thickened.

❐     Palms and soles become thickened and yellow colored in PRP.

❐     Cracks may develop which can be painful and make walking and using the hands difficult


❐     Hair may thin considerably.


❐     Shivering, heat and fluid loss


❐     Small islands of normal skin (islands of sparing) are seen within the areas of the scaly skin.

SYMPTOM Sources used in this post:








SG 02.02.02

4 Replies to “What are the symptoms of PRP?”

  1. additional symptoms:-
    Extreme itching and painful skin
    Loss of temperature control, with feeling of being cold even at warm temperatures
    Loss of energy., tiredness
    Swelling of legs and feet

    Some patients have an initial “halo” skin lesion which occurs months before any other skin lesion appears. In my case this was a raised circular lesion on my back which was not diagnosed on biopsy. It did not itch or flake. The central area of skin was uninvolved, giving the resemblance of a ringworm. I have read of this occurring in other patients. It is called a sentinel lesion I think.

  2. 332140 368980It is really a good and useful piece of info. Im glad that you just shared this useful info with us. Please keep us informed like this. Thanks for sharing. 118024

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