A Case of Stasis Papillomatosis Associated with Psoriasis Vulgaris

Abstract

A markedly obese, 41-year-old Japanese man who had suffered from psoriasis vulgaris for several years visited us with elephantiasis-like swelling of his lower legs of three months' duration. His right lower leg showed marked papillomatosis with thick scales, and the left lower leg was eroded and papillomatous. Although direct lymphography of his lower extremities showed no abnormality, indirect lymphography revealed local lymphatic damage in the involved skin. Histological examination showed hyperkeratosis, marked papillomatosis, proliferation of capillaries in the upper dermis, and lymphectasia in the lower dermis. The lesions were much improved by washing and topical use of corticosteroids for two months. It was suspected that obesity and the preceding psoriatic lesions caused local lymphatic disturbances, followed by the development of stasis papillomatosis.

Localized lymphedema (elephantiasis): a case series and review of the literature

“…[4][5][6] Histopathologically, lymphedema is a fibroinflammatory process. 7,8 Typically, elephantiasis diffusely involves the body part affected by lymphedema (legs more than arms and genitalia episodically); 8 exceptionally, lymphedema involves circumscribed region of skin producing a solitary, large polyp, indurated (solid) plaque, papillomatous plaque, [69][70][71][72][73][74][75][76][77][78][79][80] pendulous swelling [81][82][83][84][85][86][87][88][89][90] or large, sarcoma-like mass. Herein, we report the clinicopathologic findings of a consecutive series of 24 cases of localized lymphedema (elephantiasis) and review the literature on this phenomenon.…”

Psoriasis with verrucous appearance

“…Our review of the literature found four similar cases . One was reported as elephantiasis nostras verrucosa and psoriasis, and two patients were diagnosed with psoriasis verrucosa and eccrine syringofibroadenomatous hyperplasia (ESH) .…”

“…One was reported as elephantiasis nostras verrucosa and psoriasis, and two patients were diagnosed with psoriasis verrucosa and eccrine syringofibroadenomatous hyperplasia (ESH) . Sato et al . made a diagnosis of stasis papillomatosis associated with psoriasis vulgaris and suggested that the papillomatous or wart‐like changes were attributable to local lymphatic circulation disturbances and subsequent lymphedema.…”

Psoriasis verrucosa in an obese Japanese man; a prompt clinical response observed with oral etretinate

“…Psoriasis verrucosa is a peculiar clinical form of psoriasis characterized by the presence of remarkably thick and hard scales adherent to the erythematous lesions, which produce a wart‐like clinical appearance 1–3 . Despite its stable appearance, it reflects a deteriorating condition rather than an independent subtype of psoriasis.…”

“…Psoriasis verrucosa, which is characterized by a prominent thickening of the lesional stratum corneum producing a peculiar wart‐like appearance, develops in deteriorating psoriasis 1–3 . Interestingly, it is sometimes found in association with congestion of the lymphatics 2,4 . Because local lymphatic disturbances may cause the occurrence of papillomatous skin changes, i.e.…”