Acitretin + EHK = PG: Toe Web Pyogenic Granuloma in a Man with Total Body Epidermolytic Hyperkeratosis on Acitretin – Report of A Unique Occurrence

Anik Amin; Tor Shwayder


Dermatology Nursing. 2009;21(6):345-347. 

In This Article

Abstract and Introduction


A patient with total body epidermolytic hyperkeratosis who was successfully prescribed acitretin with the occurrence of a pyogenic granuloma is described in this case report.


Epidermolytic hyperkeratosis (EHK), also known as bullous congenital ichthyosiform erythroderma, is a rare autosomal dominant disease of the ichthyosis family with a prevalence of 1 in 300,000 people (Shwayder, 1999). Individuals affected with EHK have describable symptoms from birth. Babies suffering from EHK have a very weak top layer of skin which blisters easily. Scaling occurs due to hyperkeratosis, in which excess keratin is produced and causes a thickening of the skin. Those affected with EHK may also have incidents of ectropion, palmoplantar keratoderma, and frequent skin infections (Steele, Shea, & Petronic-Rosic, 2007). However, pyogenic granuloma is not one of the known associations.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.