PRP Survival Guide

A child with binoculars

What is my long-term outlook based on Type?

The long-term prognosis for PRP is not set in stone. However, there are some guidelines that dermatologists feel comfortable  treating as Gospel. Suffice it to say that there has been insufficient research to be able to predict with any precision, when a PRP journey will end. 

In March 2003, Dr. Andrew Griffiths delivered a “Dowling Oration” to members of the British Association of Dermatology assembled in Liverpool, England. Dr. Griffiths reflected on 35 years of diagnosing, treating and researching pityriasis rubra pilaris. He unilaterally set the PRP prevalence rate at one in 400,000. The following patient populations reflect September 2021 population estimates.

  • European Union: 1,115
  • United States: 830
  • United Kingdom: 167
  • Canada: 94
  • Australia: 63

While the methodology used by Dr. Griffiths is subject to debate, dermatologists worldwide have accepted his estimates.

ADULT ONSET PRP

Type 1 — Classical Adult Onset PRP

  • Odds: One in 800,000
  • Patient population percentage: 55%
  • Prognosis: 80% of the ‘active” patients will have “spontaneous” remission within two to four years
  • After remission, relapses are uncommon

Type 2 — Atypical Adult Onset PRP

  • Odds: One in 8 million
  • Patient population percentage: 5%
  • Prognosis: estimated duration: 20 years or more.

JUVENILE ONSET PRP

Type 3 — Classical Juvenile Onset PRP

  • Odds: One in 4 million
  • Patient population percentage: 10%
  • Usually occurs between the ages of 5 and 10
  • Prognosis: the average Type 3 remission is within one year

Type 4 — Circumscribed Juvenile Onset PRP

  • Odds: One in 1.6 million
  • Patient population percentage: 25%
  • Occurs in children before puberty
  • Prognosis: Long term outcome unclear but possible improvement in late teens. Not considered a long-term affliction

Type 5 — Atypical Juvenile

  • Odds: one in 8 million
  • Patient population percentage: 5%
  • Prognosis: long term, chronic

AND THERE IS ONE MORE

Type 6 — HIV-Associated PRP

  • Odds: statistically insignificant (unless you have been diagnosed with Type 6). Inclusion of a Type 6 is the subject of debate and was not included in Griffith’s list of five.
  • Disease tends to be resistant to standard therapies
  • Prognosis: No further timeframe is suggested

revised November 22, 2022