Dermatologia comparativa: psoríase hiperceratósica

Abstract

A psoríase possui diversas formas de apresentações clínicas. Lesões hiperceratósicas podem ser observadas e verificam-se na literatura diversas denominações para essas lesões, como elefanthine, rupióide, ostrácea e pseudocórnea. É interessante notar que duas dessas denominações se remetem à semelhança com conchas encontradas nos estudos de conquiliologia: rupióide e ostrácea. Os autores comparam os aspectos morfológicos das variantes da psoríase hiperceratósica com as conchas de diversas espécies de moluscos.

Case for diagnosis

“…1,2 These varieties are extremely rare, with few reports in the literature. Some authors do not distinguish between hyperkeratotic forms of psoriasis and use the terms interchangeably.…”

“…Psoriasis may present intensely hyperkeratotic lesions, thus being classified as ostraceous, rupioid and elephantine psoriasis. 1 , 2 These varieties are extremely rare, with few reports in the literature. Some authors do not distinguish between hyperkeratotic forms of psoriasis and use the terms interchangeably.…”

Elephantine psoriasis with papillomatosis and alternating hypogranulosis and hypergranulosis

“…The hyperkeratotic form, rarely reported in the literature, is further classified into ostraceous, rupioid and elephantine types. [ 1 2 ] Lesions with firmly adhered thick scales, varying color and surface resembling an oyster shell are typical features of ostraceous psoriasis. [ 3 4 ] The rupioid form is characterized by hyperkeratotic, concentric, circular and limpet like cone-shaped plaques.…”

“…[ 3 4 ] The rupioid form is characterized by hyperkeratotic, concentric, circular and limpet like cone-shaped plaques. [ 3 4 5 ] Elephantine psoriasis lesions are defined as large, thick, flat long-standing plaques, typically found in the dorsal area, buttocks, upper limbs[ 1 2 ] and often on lower limbs. [ 4 ] Some authors do not distinguish between hyperkeratotic forms of psoriasis and use the terms interchangeably.…”

Psoriasis rupioides with marked nail abnormalities in a HIV-positive patient

“…W przypadku decyzji o leczeniu miejscowym podstawą są preparaty złuszczające, tj. maści z siarką i kwasem salicylowym lub mocznikiem, aplikowane przed zastosowaniem leczenia redukującego i przeciwzapalnego [2,5,6]. Ze względu jednak na częste występowanie zmian w okolicach wyprzeniowych stosowanie leczenia miejscowego może być bardzo utrudnione z uwagi na łatwe drażnienie tych okolic.…”