A Frightening Case of PRP: How One Child Left Pityriasis Rubra Pilaris Behind

“Have you ever heard of PRP? Pityriasis Rubra Pilaris?” the woman asked on the phone. “It’s a rare skin condition. My daughter is covered with it—from head-to-toe.”

Nine-year-old Ally was generally healthy until a couple of days after an audition for modeling, which had occurred a few days after her birthday. According to her mother, Ally’s symptoms started with a reddened face that appeared dry; she also appeared to be dehydrated. Mother had applied baby oil at the time which did not help. Within a couple of days the rash began to turn white with flaking; it also moved into her scalp. She was taken to see the pediatrician who diagnosed her with eczema and gave her a topical steroid cream (Fluocinolone acetonide 0.01%) and a medicated shampoo (Capex®).

When the cream was applied, an intensely burning pain developed on the area of application. Ally was taken to the Emergency Room for treatment and evaluation; the cream was discontinued; no other treatment was given.
The medicated shampoo yielded only a brief reprieve from the scalp itching and flaking.

Within 2 weeks, the white, flaking rash spread to the rest of her body. Some areas had red, raised patches, but not all areas. The itch continued to be intense and the flaking was extreme as well.

Ally was then taken to see a Dermatologist. After a biopsy, she was diagnosed with Pityriasis Rubra Pilaris (PRP). The treatments the Dermatologist advised were researched by the mother. As she didn’t like the side effects and lack of effectiveness of the drugs; the mother made an appointment for me to work with Ally.

Pityriasis Rubra Pilaris

Pityriasis Rubra Pilaris, also called PRP, is a group of skin complaints characterized by severe scaling patches of skin and may include orange or red patches and keratotic follicular papules as well as thickening of the skin on the hands and feet.

PRP typically first occurs in childhood; the cause is unknown. The common beliefs are that a Streptococcal bacteria infection can trigger an auto-immune response while other experts believe the cause is more of a genetic origin. Recently, and HIV-associated type has been added to the list of possible causes.

As there is no medical cure for this condition, symptoms are managed with medication; the goals are to keep the flare-ups to a minimum and to keep the person in remission for as long as possible. The common drugs used are Accutane® (isotretinoin) or Trexall® (methotrexate). Due to the severe side effects of methotrexate, this drug is usually reserved for those who do not respond to Accutane®, however neither drug is recommended for children as young as Ally.

Homeopathy Lends a Hand
I had researched the medical diagnosis prior to the appointment as it was unknown to me. When selecting a Homeopathic Medicine for a person, the symptoms that are common for the disease are less important than those uncommon. Therefore, I needed to know what usually occurs with those having the diagnosis of PRP.

Even though I had seen many photos of the condition, I was surprised when I saw the child for the first time. She was, literally, covered with white flakes. Any activity caused flakes to drop—on the floor, on the chair, everywhere.

Symptoms (those underlined are unique for Ally, not to the disease):
• Severe itching skin
• Dry skin
• Skin appears white
• White flakes drop from the body during visit
o Worse with scratching
o Worse with any movement
• Covers entire body including scalp
o Worse on back
o None on thighs and calves
• Patches of red raised areas on her trunk and back
• Restlessness and fidgety; had trouble sitting still
• Continuous scratching, especially on her back as far as she could reach
• Wearing short sleeves, pants and a thin vest despite the temperature being cold in winter

Generals (all unique to Ally):
• Blonde hair.
• Blue eyes.
• Highly sensitive both emotionally and physically.
• Very dramatic; small anxieties quickly turn into major frightening experiences.
• Intelligent: an “A” student in school.
• Learns quickly.
• Aversion to lettuce, liver, macaroni, tomatoes (also caused stomach upset).
• Loves cheeseburgers and potatoes.

Other Important Details:
• Physical reaction to most vaccinations: red, sore and inflamed injection site; needed to be treated medically once after development of a large, hard lump under the skin at the injection site.
• Moderate antibiotic usage during her childhood for various infections—mostly ear and/or sinus infections.
• Gets nauseated if she skips a meal.
• Mother works as a dermatology assistant.
• Father has bipolar disease; medically-managed. Increases stress at home.
• Ally is the only female out of 5 brothers; she is the youngest child.
• Has no chronic conditions; only medical drug currently in use is the medicated shampoo.
• Takes several natural supplements: Vitamin/Mineral Multiple, Eyebright, Echinacea and Melatonin (all given per mother’s research).
• No one in the family has ever seen a natural practitioner of any kind.
• Both parents favor medical care for all things; both are “medically-minded”.

Interpretation:
• Due to the “age” of the symptoms (about 6-8 weeks) and Ally had no prior history to anything similar, this was deemed to be a sub-acute condition.
• The probable cause of the condition was the anxiety and anticipation from the audition a few days prior to the onset of the facial redness that subsequently turned into a flaking rash that spread very rapidly.
• There had been no change in the norm in her emotional or mental status after the onset of the condition; any residual anxiety or anticipation from the event has passed as her parents could not afford to pay for modeling training and for professional picture taking.
• Aside from the rash and its symptoms, there has been no change in her physical characteristics either.

Action:
• Aconitum napellus 200C (ailments after fright, anticipation, anxiety).
• Call with update in 2 weeks.
• Be evaluated in 4 weeks if not completely healed.

Reasoning & Rationale:
• Child was healthy until the modeling audition, leading me to believe that the cause of the symptoms was an emotional reaction.
• As the symptoms were acute in nature, an emotional remedy would be the best indicated and would most likely lead to a complete resolution of the physical characteristics that had presented themselves.
• Aconitum napellus (also called “Aconite”) is the best Homeopathic Remedy for ailments after frightening situations and for anything that is severe and/or intense; also for traumas and situations that happen suddenly. Ally had severe and intense symptoms following a fright; the physical symptoms started very soon after the fright.

Response:
• I received no call in 2 weeks and did not re-evaluate Ally in 4 weeks.
• I received an email six months later to give me an update: “...I have been meaning to get in touch with you because she is doing so much better! I’m not sure if it was the remedy that you suggested, the love of the brown stuffed bear (Brownie) that you gave her, or what that cured her… thank you for your help in having her disease go into remission...”
• Ally’s rash had completely disappeared within 1 week of taking the dose of Aconite.
• Case closed.

Conclusion
It has now been over 2 years since the first day I saw Ally. Her rash has not returned after that one dose of Aconite. With Classical Homeopathy, the person is the focus, not the disease. Had I only looked at her physical symptoms, even those that occur with most people who are diagnosed with PRP, Aconite would not have been the recommended remedy. I know that Aconite worked—I do not believe another remedy, even one that addressed all of the physical symptoms, would’ve caused the same result.

When it’s time to heal, call a Classical Homeopath.

Best wishes,
Dr. Ronda