Trachyonychia with Juvenile Pityriasis Rubra Pilaris

A three-and-a-half-year-old boy with juvenile pityriasis rubra pilaris (PRP) presented with distinctive orange-red plaques and nail changes indicative of trachyonychia, a condition not previously reported in PRP patients. The diagnosis was confirmed through clinical and histopathological correlation, revealing mild acanthosis and parakeratosis without significant inflammation. Treatment with topical calcipotriol, clobetasol cream, white soft paraffin, and oral biotin led to marked improvement in both skin and nails within 2 months, with complete resolution over 6 months and no relapse in the following 2 months. This case highlighted the good prognosis and effective response to simple topical therapy in juvenile PRP with trachyonychia.