Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris—A systematic review

BackgroundPityriasis rubra pilaris is a chronic, scaly, keratotic skin disease, mainly manifested as scaly plaques and keratinized hair follicles. This condition significantly impacts the patient’s quality of life and is considered one of the intractable diseases in dermatology. Currently, no satisf...

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Main Authors: Xiaofang Zhang, Kebo Wei, Hongxia Song, Xi Chen, Jiao Yang, Jianmei Zhao, Yugu Jiang, Xin He
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1544197/full
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author Xiaofang Zhang
Kebo Wei
Hongxia Song
Xi Chen
Jiao Yang
Jianmei Zhao
Yugu Jiang
Xin He
author_facet Xiaofang Zhang
Kebo Wei
Hongxia Song
Xi Chen
Jiao Yang
Jianmei Zhao
Yugu Jiang
Xin He
author_sort Xiaofang Zhang
collection DOAJ
description BackgroundPityriasis rubra pilaris is a chronic, scaly, keratotic skin disease, mainly manifested as scaly plaques and keratinized hair follicles. This condition significantly impacts the patient’s quality of life and is considered one of the intractable diseases in dermatology. Currently, no satisfactory clinical treatment options are available for this condition, presenting a considerable challenge for dermatologists. We conducted this systematic evaluation to assess the therapeutic potential of existing small molecule drugs for this disease.ObjectivesTo conduct a systematic review of the existing literature on the use of small molecule drugs for treating pityriasis rubra pilaris and to evaluate their clinical effectiveness and safety.MethodsWe conducted a systematic review of all the literature on small molecule drugs for the treatment of Pityriasis rubra pilaris and searched several databases until November 2024, including PubMed, Embase, Web of Science, and the Cochrane Library.ResultsA total of 16 patients with pityriasis rubra pilaris from 11 publications were included. The small molecule drugs, including apremilast, upadacitinib, abrocitinib, and tofacitinib, demonstrate good efficacy and safety in the treatment of pityriasis rubra pilaris across all ages, particularly in patients who have failed systemic therapy and have a poor response to biological agents. However, the conclusions are limited by the small sample size and need to be further confirmed through large-scale randomized controlled clinical trials.ConclusionSmall molecule drugs demonstrate favorable clinical efficacy and safety in the treatment of refractory pityriasis rubra pilaris, exhibiting a relatively rapid onset and a high safety profile. However, the findings in the literature may be affected by publication bias.
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spelling doaj-art-3e10c23fc9784e9091aa96c4fe0b4f002025-08-20T02:57:05ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-02-011210.3389/fmed.2025.15441971544197Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris—A systematic reviewXiaofang Zhang0Kebo Wei1Hongxia Song2Xi Chen3Jiao Yang4Jianmei Zhao5Yugu Jiang6Xin He7Department of Dermatology, Sichuan Mianyang 404 Hospital, Mianyang, Sichuan, ChinaDepartment of Dermatology, Sichuan Mianyang 404 Hospital, Mianyang, Sichuan, ChinaDepartment of Dermatology, Sichuan Mianyang 404 Hospital, Mianyang, Sichuan, ChinaDepartment of Dermatology, Sichuan Mianyang 404 Hospital, Mianyang, Sichuan, ChinaDepartment of Dermatology, Sichuan Mianyang 404 Hospital, Mianyang, Sichuan, ChinaDepartment of Dermatology, Sichuan Mianyang 404 Hospital, Mianyang, Sichuan, ChinaDepartment of Dermatology, Hospital of Chengdu University of TCM, Chengdu, Sichuan, ChinaDepartment of Dermatology, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, ChinaBackgroundPityriasis rubra pilaris is a chronic, scaly, keratotic skin disease, mainly manifested as scaly plaques and keratinized hair follicles. This condition significantly impacts the patient’s quality of life and is considered one of the intractable diseases in dermatology. Currently, no satisfactory clinical treatment options are available for this condition, presenting a considerable challenge for dermatologists. We conducted this systematic evaluation to assess the therapeutic potential of existing small molecule drugs for this disease.ObjectivesTo conduct a systematic review of the existing literature on the use of small molecule drugs for treating pityriasis rubra pilaris and to evaluate their clinical effectiveness and safety.MethodsWe conducted a systematic review of all the literature on small molecule drugs for the treatment of Pityriasis rubra pilaris and searched several databases until November 2024, including PubMed, Embase, Web of Science, and the Cochrane Library.ResultsA total of 16 patients with pityriasis rubra pilaris from 11 publications were included. The small molecule drugs, including apremilast, upadacitinib, abrocitinib, and tofacitinib, demonstrate good efficacy and safety in the treatment of pityriasis rubra pilaris across all ages, particularly in patients who have failed systemic therapy and have a poor response to biological agents. However, the conclusions are limited by the small sample size and need to be further confirmed through large-scale randomized controlled clinical trials.ConclusionSmall molecule drugs demonstrate favorable clinical efficacy and safety in the treatment of refractory pityriasis rubra pilaris, exhibiting a relatively rapid onset and a high safety profile. However, the findings in the literature may be affected by publication bias.https://www.frontiersin.org/articles/10.3389/fmed.2025.1544197/fullpityriasis rubra pilarissystematic reviewsmall molecule drugsefficacy and safetJanus kinase (JAK) inhibitorsPDE-4 inhibitor
spellingShingle Xiaofang Zhang
Kebo Wei
Hongxia Song
Xi Chen
Jiao Yang
Jianmei Zhao
Yugu Jiang
Xin He
Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris—A systematic review
Frontiers in Medicine
pityriasis rubra pilaris
systematic review
small molecule drugs
efficacy and safet
Janus kinase (JAK) inhibitors
PDE-4 inhibitor
title Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris—A systematic review
title_full Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris—A systematic review
title_fullStr Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris—A systematic review
title_full_unstemmed Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris—A systematic review
title_short Efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris—A systematic review
title_sort efficacy and safety of small molecule drugs in the treatment of pityriasis rubra pilaris a systematic review
topic pityriasis rubra pilaris
systematic review
small molecule drugs
efficacy and safet
Janus kinase (JAK) inhibitors
PDE-4 inhibitor
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1544197/full
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