Circumscribed juvenile type pityriasis rubra pilaris (type 4): are we missing them?

Pityriasis rubra pilaris (prp) is a rare disease. the lack of pathognomonic features and specific clinical or diagnostic features often make identification of prp very difficult. prp type 4 (circumscribed juvenile type) is characterized by scaly plaques on elbows, knees and palmoplantar keratoderma. sometimes these lesions may become extremely difficult to differentiate from those of psoriasis. we report 3 cases of prp type 4, noted in just 5 months. we feel prp, specially the type 4, is not so rare in indian subcontinent. a good clinical knowledge and high index of suspicion may help to identify more cases.