Juvenile acute pityriasis rubra pilaris (JAPRP) is a form of pityriasis rub
ra pilaris (PRP) with particular clinical characteristics and course. It is
usually preceded by an infectious condition. We report a boy, initially th
ought to have Kawasaki disease, and subsequently diagnosed as having JAPRP,
who made a satisfactory recovery. In this case, prior antibiotic treatment
made it impossible to show the presence of any microorganism. However, the
clinical characteristics of these patients and the similarities with other
disorders involving the skin that are mediated by superantigens led us to
think that these antigens may be involved in the development of this diseas
e. Also, in view of the obvious differences between JAPRP and the other PRP
, we suggest that, in the future this disorder may be considered a separate
entity as a reactive exanthem.