Unilateral Verrucous Psoriasis

Abstract

Verrucous psoriasis is a variant of psoriasis that presents with wartlike clinical features and overlapping histologic features of verruca and psoriasis. The disease typically arises in patients with established psoriasis but can occur de novo. We report the case of an 80-year-old man with a history of hypertension and coronary artery disease who presented with a rash characterized by multiple asymptomatic plaques with overlying verrucous nodules on the left side of the body. The lesions appeared shortly after coronary artery bypass surgery with a saphenous vein graft.

Single-plaque psoriasis: a single-clue diagnostic challenge

“…A potential explanation for de novo unilateral psoriasis could be represented by genetic mosaicism [7], however other researchers suggest that neuropeptides released consecutive to nerve injury may trigger de novo psoriasis lesions [5]. These hypotheses require a series of in vitro, ex vivo and in vivo studies to be confirmed.…”

“…Scientific literature regarding unilateral psoriasis cases hypothesizes that in younger patients, unilateral lesions appear de novo, whereas in older patients, unilateral psoriasis lesions are reported consecutive to skin trauma such as surgical lesions [5]. In the second situation, the Koebner phenomenon explains the occurrence of the psoriasis lesion; psoriasis lesions are expected to occur within 10-20 days post-injury, however cases have been reported ranging from 3 days to 2 years post-surgical trauma [6].…”

Unilateral Verrucous Psoriasis Successfully Treated With Adalimumab

“…Verrucous psoriasis (VP) is a rare variant of psoriasis that typically arises in patients with established psoriasis but can occur de novo [ 1 ]. There is a higher prevalence in men [ 2 ].…”