Follicular Psoriasis - A Forgotten Entity?~!2010-04-15~!2010-07-06~!2010-08-06~!

Abstract

Follicular psoriasis is a common yet under reported entity. Major dermatology textbooks fail to emphasise and even neglect this important diagnosis and since its original description in 1920 there have been only three reports in the published literature. As a result the diagnosis is seldom entertained by dermatology trainees in the differential diagnosis of a folliculocentric skin disease. We present a case of follicular psoriasis which was initially mis-diagnosed as lichen planopilaris and summarise the key features of this neglected entity. Our aim is to highlight awareness of this disorder and we also propose that the follicular variant be included as a psoriasis subtype in standard dermatology textbooks.

Follicular psoriasis: a report of 5 cases and review of the literature, likely an under-recognized yet distinctive variant of psoriasis

“…This patient had no previous diagnosis of psoriasis and lacked the classical findings for psoriasis vulgaris. Thomas et al presented a case in an 18year-old Asian male who exhibited bilateral follicular lesions involving the thighs, calves, and arms, initially misinterpreted as lichen planopilaris [9]. Patil et al described a 13-year-old boy with symptomatic scaling and erythema of the skin that began as horny papules on the knees and elbows that evolved into erythematous scaly papules encompassing the entire body [10].…”

“…The clinical presentations and microscopic examinations in the previously described reports were similar to the findings in our cases. A summary of these 25 cases is presented in Table 1 [6][7][8][9][10].…”

Follicular Psoriasis: A Case Report and Review of Literature

“…Keratin 17 (K17) is a structural protein found in basal cells of various complex epithelial tissues like nails, hair follicles, sebaceous glands, and eccrine sweat glands. Thomas et al [13] (2010), UK Recently, it has gained attention in psoriasis research as studies have shown its abnormal expression in suprabasal layers of keratinocytes in psoriatic lesions as compared to normal skin. Cytokines (including IL-17A and IL-22) which are associated with the Th17 and IL-22-producing CD4+ T cells, can increase K17 expression in keratinocytes.…”

A Systematic Review of Follicular Psoriasis: A Unique but Under-Recognized Entity

“…Since this initial publication, occasional additional cases of FP have been reported. [2][3][4][5][6][7][8][9][10][11] The current literature emphasizes the distinction of this condition from the cutaneous manifestation of classical psoriasis variants and stresses diagnostic difficulty due to its apparent rarity and relatively unfamiliar clinical presentation. This study aims to analyze the clinical, histological, and dermatoscopic findings as well as treatment options of all FP cases reported in the literature.…”