Rupioid psoriasis with arthropathy.
A 31-year-old male presented with limpet-like, cone-shaped skin lesions on the scalp, the extremities, and the trunk of 4 months' duration, and had had severe joint pain in his right fingers, wrist, and knee for 1 month. Radiological examination revealed arthritis of the above mentioned multiple joints. Rheumatoid factor was serologically negative. Histopathological findings showed dense inflammatory cell infiltration and remarkable Munro's microabscesses in the horny layer in addition to psoriasiform epidermal hyperplasia, and predominant dermal oedema. Based on clinicopathological findings, a diagnosis of rupioid psoriasis with arthropathy was made. Following treatment for arthralgia using low doses of systemic steroid, the effects of cyclosporin combined with topical steroids was seen to alleviate dramatically the skin lesions and arthritis within 2 weeks. There was no recurrence of such skin and joint lesions during a follow-up period of 1 year.
Murakami
T
T
Department of Dermatology, Jichi Medical School, Minamikawachi-machi, Kawachi-gun, Japan. takmu@jichi.ac.jp
Ohtsuki
M
M
Nakagawa
H
H
D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D003524:Cyclosporins / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005384:Finger Joint / Q000000981:diagnostic imaging; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D011239:Prednisolone; D011859:Radiography; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D003524:Cyclosporins; D005938:Glucocorticoids; D011239:Prednisolone