Pityriasis rubra pilaris and celiac sprue with malabsorption.

A case is reported herein of a young man with pityriasis rubra pilaris, a disease of unknown cause, and malabsorption due to celiac bowel disease. The patient responded to high-dose vitamin A therapy (500,000 IU orally per day for fourteen days). There was complete exfoliation of the palmar-plantar keratoderma and a decrease in the peeling and follicular keratosis. He was then placed on a regimen of a gluten-free diet and 100,000 IU vitamin A per day. After seven months he had persistent erythema but minimal hyperkeratosis. The ways in which cutaneous lesions and malabsorption could be related are discussed.