|Year : 1999 | Volume
| Issue : 2 | Page : 82-83
Mittal RR, Seema Gupta, Ramesh Jindal
Source of Support: None, Conflict of Interest: None
A 6-year-old male child had linear scaly erythematous band on the penis, undersuface of penis, extending to the scrotum since birth. He was diagnosed clinically as well as histopathologically as a case of naevoid psoriasis.
Keywords: Naevoid, Koebner Phenomenon, Psoriasis
|How to cite this article:|
RR M, Gupta S, Jindal R. Naevoid psoriasis. Indian J Dermatol Venereol Leprol 1999;65:82-3
| Introduction|| |
Psoriasis may occur in naevoid form very rarely, possibly reflecting mosaicism for the gene responsible for psoriasis. Bennet et al reported a case of psoriasis limited to areas, of systematized epidermal naevus due to isomorphic phenomenon. A case of genuine naevoid form of psoriasis in a 6-year-old child comprising multiple psoriasiform plaques, arranged in linear bands distributed along the Lines of Blaschko More Details, confined to left side of body has also been reported. It has to be differentiated from linear psoriasis representing koebner's phenomenon which can appear at any age.
| Case Report|| |
A 6-year-old male child presented with linear scaly erythematous plaque-type of lesion on the penis, undersurface of penis extending to the scrotum since birth. There was history of impetiginisation, mild itching, and partial regression of lesion with topical steroids. There was no fever, oedema, arthralgia or family history of psoriasis. General physical and systemic examination were normal. Local examination revealed a scaly, erythematous, 3-5mm vide linear band arising from median of posterior surface of scrotum, crossing whole of anterior surface of scrotum upto penoscrotal junction and turning towards the right side of penis to the anterior surface and ending at tip of penis. On the anterior aspect of penis, linear band consisted of three plaques measuring approximately 1X 1.2cm, 0.5X0.7cm, and 0.4X0.6cm joind with one another [Figure - 1]. Plaques were well defined, erythematous, salmon pink in colour with silvery white scales. Auspitz sign was negative. No associated changes in nails, scalp or mucous membranes were seen.
Routine laboratory tests on blood and urine were normal. Biopsy from plaque lesion showed acanthosis, focal parakeratosis, and elongation of the rate ridges some of which were club shaped. Dermal papillae were infiltrated by mononuclear cells. Vessels were dilated.
| Discussion|| |
Naevoid psoriasis has to be differentiated from other disorders with scaly erythematous plaques arranged in linear fashion i.e inflammatory linear verrucous epidermal naevus (ILVEN), lichen striatus, linear lichen planus, linear Darter's disease and neurodermatitis. Linear LP and linear Darter's disease are easily differentiated on histological grounds. Lichen striatus and neurodermatitis are not present since birth and are usually associated with moderate to intense pruritus. remissions and relapses and histopathologically no spongiosis or vesiculation was observed. Final diagnosis of naevoid psoriasis was established by typical histopathology of psoriasis, its presence since birth, persistent nature and absence of pruritus.
| References|| |
|1.||Rook A, Wilkinson DS, Ebling FJG, et al. Naevoid psoriasis, in: Textbook of Dermatology, 5th Edn, Scinetific Publications Oxford, 1992;1:454. |
|2.||Bennett RG, Burnus L, Wood SG. Systematised epidermal nevus: a determinant for the localisation of psoriasis. Arch Dermatol 1973;108:7057. |
|3.||Atherton DJ, Kahana M, Jones R. R. Naevoid psoriasis. Br J Dermatol 1989;120:837-841. [PUBMED] [FULLTEXT]|
|4.||Melski JW, Bernhard JD, Stern RS. The koebner (isomorphic) response in psoriasis. Arch Dermatol 1983;119:655-659. [PUBMED] [FULLTEXT]|
[Figure - 1]