Abstract: An 8-month-old male child presented with generalized scaly erythematous plaques accompanied by palmar and plantar hyperkeratosis persisting for over one month. Biopsy of skin lesions revealed hyperkeratosis with parakeratosis, granulosa thickening, epidermal psoriatic hyperplasia, mild intercellular edema, dermal papillary extension, telangiectasia, and a small amount of perivascular lymphocyte infiltration The diagnosis of pityriasis rubra pilaris was made. The child was treated with oral azithromycin and topical medications and the maculopapules subsided, scales decreased significantly, palmar and plantar keratosis subsided, no new rash occurred, diet and sleep improved after treatment for 1 month.

Key words: pityriasis rubra pilaris, azithromycin