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Parapsoriasis, Large Plaque

Mary E. Maloney, MD and Vijaya T. Daniel, MD, MPH Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Parapsoriasis describes a group of cutaneous diseases characterized by scaly patches or plaques that resemble psoriasis.

  • There are three main types of parapsoriasis:

    • Pityriasis licheno...

DIAGNOSIS

  • LPP is a chronic condition that develops progressively from a few patches into more visible ones over decades.

  • LPP, as opposed to small plaque parapsoriasis, does not enter remission without ...

TREATMENT

Treatment may prevent progression to CTCL. 

MEDICATION

First Line

  • Mid- to high-potency topical steroid cream applied 1 to 2 times daily (classes II to IV)

  • Topical tar products

  • Phototherapy with b...

ONGOING CARE

Follow-up every 3 to 6 months. Increasing number of lesions, increase in lesion size, or the development of induration or epidermal atrophy should prompt a repeat skin biopsy. 

PROGNOSIS

  • LP...

REFERENCES

1
Bordignon  M, Belloni-Fortina  A, Pigozzi  B, et al. The role of immunohistochemical analysis in the diagnosis of parapsoriasis. Acta Histochem.  2011;113(2):9...

ADDITIONAL READING

  • Kreuter  A, Bischoff  S, Skrygan  M, et al. High association of human herpesvirus 8 in large-plaque parapsoriasis and mycosis fungoides. Arch Dermatol. &#...

CODES

ICD10

L41.4 Large plaque parapsoriasis 

SNOMED

67081008 Large plaque parapsoriasis (disorder) 

CLINICAL PEARLS

  • LPP presents as irregularly shaped scaly plaques >6 cm in diameter with smooth, round borders, and epidermal atrophy.

  • Look for the “bathing suit” distribution of plaques.

  • LPP develops...

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