Erythrodermic verrucous psoriasis

Abstract

Verrucous psoriasis is characterized clinically by symmetric hypertrophic verrucous plaques on an erythematous base and histologically by overlapping features of both verrucae and psoriasis with negative human papilloma virus (HPV) studies. A 46-year-old African-American male presented with an 8-year history of extensive malodorous, symmetric, verrucous plaques manifesting as erythroderma. Biopsies showed epidermal hyperplasia and papillomatosis, parakeratosis with neutrophils, and dilated vessels in the dermal papillae. The polymerase chain reaction of lesional skin was negative for HPV DNA, and T-cell gene rearrangement was negative. The patient was diagnosed with erythrodermic verrucous psoriasis. Verrucous psoriasis is a rare presentation of psoriasis and has only been reported as a localized variant. To the authors' knowledge, erythrodermic verrucous psoriasis has not been reported. This presentation was a diagnostic and therapeutic challenge and serves to heighten the awareness of a unique variant of psoriasis.

Verrucous psoriasis: A rare variant of psoriasis masquerading as verrucous carcinoma

“…VC is commonly associated with human papilloma virus (HPV) infection, which can be evaluated with p16 immunohistochemical staining 1 . p16 is overexpressed in HPV-driven tumors because of HPV-related E6 and E7 oncogenes inhibiting Rb, leading to p16 disinhibition; a negative test result can help confirm a diagnosis of VP 7, 8. Staining was not pursued in this case because the tumor seemed locally aggressive, so the results would not have changed management.…”

Psoriasis with verrucous appearance: a case report

“…Verrucous psoriasis is a rare variant of the disease with less than thirty cases reported in the literature [3]. It is mostly occurring on men with a sex ratio of 1.6 and a mean age of 53 year old [1,4]. Clinically, VP is characterized by a scaly erythematous plaque with verruca vulgaris, epidermal nevus, contact dermatitis, eczema and fungal infection [1].…”

Advanced aging skin and itch: addressing an unmet need

“…Epidemiological studies conducted in nursing homes populations have reported 30 to 75% prevalence of xerosis in the elderly [1, 9]. Additional studies examining individuals living in the community yielded similarly high prevalence rates, ranging from 55 to 85% [10, 11]. These results suggest that xerosis is a widespread condition regardless of individual living or care settings.…”

“…As a result, the present authors recommend always including xerosis cutis in the differential for pruritus in elderly patients even if they are unable to identify the severity of skin dryness. According to a cross-sectional study examining 756 French patients older than the age of 65 years in an ambulatory primary care setting, potential risk factors associated with xerosis include increasing age, female gender, certain medications, pruritus during sweating, and a history of atopic dermatitis (10). Xerosis can occur secondary to underlying medical conditions such as human immunedeficiency virus (HIV) infection, thyroid disease, diabetes, or malignancy.…”