rupioid psoriasis

Etiology

• HIV1 infection
• medications
  • lithium carbonate
  • hydroxychloroquine
  • beta-blockers

Pathology

• skin biopsy
  • confluent parakeratosis
  • neutrophils within the stratum corneum
  • diminished granular layer
  • psoriasiform hyperplasia
  • telangiectasia within dermal papillae

Clinical manifestations

• papulosquamous eruption
• erythematous circular plaques, with thick concentric ringlike scale
  • concentric conelike scale* with appearance similar to limpet shells
• palmoplantar keratoderma
• no nail changes.

* images

Differential diagnosis

• secondary syphilis
• hyperkeratotic scabies
• HIV1 infection
• reactive arthritis
• disseminated histoplasmosis

* may be same entity as ostraceous psoriasis

Management

• resistant to topical treatment
• systemic agents with reported benefit
  • acitretin
  • cyclosporine
  • methotrexate
  • adalimumab
  • ustekinumab

More general terms

• psoriasis