Severe Pityriasis Rubra Pilaris Complicated With Kaposi's Varicelliform Eruption and Cutaneous MRSA Infection: Case Report

A 62-year-old woman with severe pityriasis rubra pilaris (PRP) experienced complications including Kaposi's varicelliform eruption (KVE) and a methicillin-resistant Staphylococcus aureus (MRSA) infection, initially misdiagnosed as psoriasis. Despite methotrexate treatment, her condition worsened, leading to erythroderma, hair loss, and nail changes. A comprehensive evaluation ruled out other disorders, and treatment with intravenous corticosteroids, antibiotics, antiviral drugs, and isotretinoin resulted in significant improvement. After 43 weeks of isotretinoin, her skin was nearly clear, and hair and nails regrew. This case highlights the complexity of diagnosing and treating PRP with concurrent infections and demonstrates isotretinoin as an effective treatment option, emphasizing the need for awareness of KVE in PRP patients and appropriate treatment protocols.