Keratodermic sandles is a feature of ?

Ans. is `d' i.e., Pityriasis rubra pilaris Pityriasis rubra pilaris It is a chronic papulosquamous disorder of unknown etiology characterized by : ? Scaling (Pityriasis means scaling Skin disorder) Erythmatous plaque (Rubra) Follicular papules (Pilaris) Hence the name pityriasis rubra pilaris. Two peaks of age are seen : ? 5-10 years in juvenile type 40 - 60 years in adult type Clinical presentation Characteristic lesions are erythmatous (orange to pink), follicular, scaly plaques. A characteristic feature of plaques is the presence of distinct islands of normal skin. Sites of predilection Trunk --> Lesions on the trunk evolve in craniocaudal (Cephalo caudal) direction. Typically, follicular lesions are seen on the dorsum of hands on knuckles --> Nutmeg papules. Associated features Diffuse erythema and scaling of face. Orangish thickening of palms and soles (Keratodermic sandals). Nails --> Distal yellow brown discoloration and nail plate thickening. Complications Erythroderma Treatment Localized lesions --> Topical coicosteroids + Keratolytics (Salicylic acid, urea) Erythroderma -4 Vitamin A, Acitretin (Retinoids), oral methotrexate