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

Erythrodermic verrucous psoriasis

“…Reported treatment options for VP include both topical and systemic agents typically used in other forms of psoriasis, with anecdotal evidence supporting response to oral retinoids (2,6,8,9). It appears that this form of psoriasis only partially responds to biologics.…”

“…VP has only been reported as individual plaques. A literature search reveals only a small number of reports of this entity: an annular variant of VP (6), VP presenting after interferon treatment for hepatitis C virus (7), and VP presenting in a Japanese male responding to oral etretinate (2).…”

“…Verrucous psoriasis (VP) is a rare atypical presentation of psoriasis that can be a diagnostic and therapeutic challenge. This variant is characterized clinically by hypertrophic verrucous plaques on an erythematous base and pathologically by overlapping features of both verrucae and psoriasis (1)(2)(3)(4). We describe a patient with erythrodermic verrucous psoriasis in order to better characterize this rare variant and heighten the awareness of its unique presentation.…”

Favorable response to apremilast in a patient with refractory psoriasis verrucosa

“…Psoriasis verrucosa, a rare subtype of psoriasis, is clinically characterized by bizarre, papilloma‐like appearance with wart‐like thick scales . It develops from pre‐existing psoriasis in patients, who may be affected by venous stasis, lymphedema, or with dysfunction of metabolic condition such as obesity and diabetes mellitus . Despite being intractable, PsVC has been treated with antipsoriatic therapies including topical treatments and systemic administrations including etretinate, cyclosporin or biologic anti‐TNF antibody.…”

“…Psoriasis verrucosa (PsVC) is a rare subtype of psoriasis characterized by a bizarre, papilloma‐like appearance with wart‐like thick scales . Although the pathoetiology of PsVC is unknown, it develops from pre‐existing psoriasis, and may be associated with varicose veins in the lower extremities or dysfunction of metabolic condition such as obesity and diabetes mellitus . No definitive treatment has been established, while a small number of published cases have been treated with conventional antipsoriatic therapies including oral etretinate and tumor necrosis factor (TNF) inhibitor .…”