Childhood-onset pityriasis rubra pilaris treated with methotrexate administered intravenously

ABSTRACT

Generalized pityriasis rubra pilaris developed in a male infant at the age of three weeks. He was treated at the Cleveland Clinic from the age of seven to 24 years, when he was lost to follow-up in 1981. His incapacitating disease stubbornly resisted many forms of therapy, including oral methotrexate, but responded satisfactorily to intravenous methotrexate given once every two weeks. Five attempts to withdraw the methotrexate resulted in prompt relapse into generalized, scaling erythroderma, accompanied by severe depression with suicidal tendencies. During the five years that he took intravenous methotrexate the patient had no discernible ill effects from the drug.