Elephantine psoriasis with papillomatosis and alternating hypogranulosis and hypergranulosis

Koley, Sankha; Mandal, Rajesh Kumar; Chatterjee, Kingshuk; Hassan, Sk Masud; Pathak, Swapan

doi:10.4103/0019-5154.156367

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…Hyperkeratotic, concentric, circular, and cone-shaped lesions that resemble limpets are what distinguish the rupioid form. Elephantine psoriasis lesions have massive, thick, at, persistent plaques [8]. Our patient presented with elephantine and rupioid psoriasis on the abdomen and back, respectively.…”

Section: Discussionmentioning

confidence: 73%

Complete response with guselkumab in a patient with double presentation of recalcitrant hyperkeratotic psoriasis over 18 months: a case report

Saleh

2024

Ann. Med. Surg. Dermatol.

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Background: Psoriasis is a chronic in ammatory skin disease with many clinical presentations. The most common variety is chronic plaque psoriasis. Rare chronic plaque psoriasis subtypes include annular, licheni ed, and hyperkeratotic. Hyperkeratotic forms include ostraceous, rupioid, and elephantine. Some authors ignore the distinction between the types of hyperkeratotic psoriasis. Nevertheless, biological therapies have not been extensively researched in such rare cases of psoriasis. We present a case of intractable hyperkeratotic psoriasis that was successfully treated with guselkumab. Case presentation: According to the physical examination of our 45-year-old male patient, the abdomen had con uent plaques and thick sero-exudative crusts. Erythematous, crusted, limpet-like lesions covered the back. The scales passed the Grattage test. The biopsy showed psoriasis features. After two months of guselkumab therapy, lesions were PASI 100. After a year of 8-week guselkumab medication, the patient's reaction was unchanged. Accordingly, guselkumab was given every 10 weeks for six months. The patient was disease-free except for a few minor lesions on the back and abdomen that disappeared following topical steroid cream. Conclusions: Our patient had elephantine and rupioid psoriasis on the abdomen and back, respectively. This twofold presentation in the same patient supports the idea that hyperkeratotic psoriasis subtypes are interchangeable. The natural evolution of hyperkeratotic psoriasis lesions may explain this appearance, which has never been recorded. In this case report, guselkumab was highly e ective at treating severe hyperkeratotic psoriasis in a real-world clinical environment for 1.5 years.

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Section: Discussionmentioning

confidence: 73%

Complete response with guselkumab in a patient with double presentation of recalcitrant hyperkeratotic psoriasis over 18 months: a case report

Saleh

2024

Ann. Med. Surg. Dermatol.

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“…• Definition: Rupioid, elephantine, and ostraceous psoriasis are rare forms which are characterized by hyperkeratotic lesions and are considered a type of chronic plaque psoriasis. Some authors use the terms rupioid, elephantine, and ostraceous as synonyms (Koley et al 2015;Nascimento et al 2015). • Clinical feature: Rupioid form is characterized by welldemarcated, circular, and limpet-like cone-shaped plaques (Bonciani et al 2015;Koley et al 2015;Chung et al 2014) (Fig.…”

Section: 5mentioning

confidence: 99%

“…Some authors use the terms rupioid, elephantine, and ostraceous as synonyms (Koley et al 2015;Nascimento et al 2015). • Clinical feature: Rupioid form is characterized by welldemarcated, circular, and limpet-like cone-shaped plaques (Bonciani et al 2015;Koley et al 2015;Chung et al 2014) (Fig. 18).…”

Section: 5mentioning

confidence: 99%

“…Treatment is similar to that used for chronic plaque psoriasis; however, systemic therapy is usually required when there are multiple and thick lesions (Chung et al 2014;Feldman et al 2008). • Differential diagnosis: Secondary syphilis, keratotic scabies, histoplasmosis, actinic porokeratosis, and inflammatory linear verrucous epidermal nevus (Koley et al 2015;Chung et al 2014;Menon 2011).…”

Section: 5mentioning

confidence: 99%

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