psoriasis | Acta Medica Marisiensis

Single-plaque psoriasis: a single-clue diagnostic challenge

Luminita Emilia Decean¹, Roxana Flavia Ilies², Andreea Sasu³, Iulia Barsan⁴, Adriana Mihai¹

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
3. First Psychiatric Clinic, Targu Mures County Hospital, Romania.
4. Elitemed Anatomical Pathology Laboratory, Targu Mures, Romania

DOI: 10.2478/amma-2022-0019

Introduction: Psoriasis is a chronic, common immune inflammatory condition of the skin, affecting 2-3% of the population, with regional variability. Classically, psoriasis presents as one of the following types: plaque, guttate, inverse, pustular or erythrodermic psoriasis. Typically, the patient will present with several symmetric psoriatic plaques on typical areas of the body, leading the clinician towards the diagnosis of psoriasis.
Case report: The present case report series focuses on an atypical presentation of psoriasis noted in 2 patients who presented to our office with a single large, erythematous plaque located on the lower leg. Due to poor response to previous treatment, a biopsy was performed and upon analysis, revealed a diagnosis of psoriasis. The lesions showed significant improvement under local therapy.
Conclusion: In spite of significant research on such a common and seemingly well-understood dermatosis, the present case reports plead for further study with regards to atypical presentations of psoriasis.

The value of Histopathological Diagnosis in Rupoid Psoriasis Accompanied by Fever. A Case Report and a Review of the Literature

Morariu SH¹, Badea MA^2*, Vartolomei MD³, Badea Iudita Maria⁴, Cotoi OS⁵

1 Department of Dermatology, University of Medicine and Pharmacy Tîrgu Mureș, Romania
2 Dermatology Clinic, County Hospital Tîrgu Mureș, Romania
3 Department of Molecular and Cell Biology, University of Medicine and Pharmacy Tîrgu Mureș, Romania
4 Anesthesiology and Intensive Care Medicine Clinic, Emergency County Hospital Tîrgu Mureș, Romania
5 Department of Pathophysiology, University of Medicine and Pharmacy Tîrgu Mureș, Romania

DOI: 10.1515/amma-2015-0010

Psoriasis is a common dermatosis, however the rupoid type is considered as an exceptional form of this disease. Rupoid scabs are very rare in dermatological daily practice, usually being seen as secondary to syphilis in immunosuppressed patients. Rupoid psoriasis is characterized by thick and multilayered crusts that are resistant to local therapy and present a sudden onset. Severe arthropathy is a common manifestation. We did not found in literature any association of rupoid psoriasis with intermittent fever. We present the case of a patient who exhibited a rush of rupoid boards with severe arthralgia accompanied by intermittent fever. The suspicion of malignant syphilis was raised considering the clinical signs and symptoms and the specific social context of STDs. This suspicion was unconfirmed by TPHA negative reaction and histopathological appearance that showed changes typical of psoriasis. Clinical manifestations were successfully controlled with methotrexate.