Parapsoriasis Clinical Presentation

Updated: Oct 07, 2021
  • Author: Henry K Wong, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Onset of parapsoriasis is indolent. It develops from a few patches and becomes more visible over a protracted period of time. Additional lesions develop progressively in some individuals.

Small plaque parapsoriasis can last months to several years; the disease often resolves spontaneously.

Large plaque parapsoriasis is a chronic disorder that manifests in an indolent manner and progresses over many years, sometimes decades. It may progress to mycosis fungoides (MF), a cutaneous T-cell lymphoma (CTCL), after an indeterminate number of years.

Large plaque parapsoriasis does not enter remission without treatment.

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Physical Examination

Lesions of small plaque parapsoriasis are well-circumscribed, slightly scaly, light salmon-colored patches that measure less than 5 cm in diameter and are scattered over the trunk and extremities. Digitate pattern is a distinctive form of small plaque disease that consists of palisading elongated fingerlike patches that follow the dermatome and are most prominently displayed on the lateral thorax and abdomen. [15] (See the images below.)

Small plaque parapsoriasis. Small plaque parapsoriasis.
Small plaque parapsoriasis. Small plaque parapsoriasis.

Large plaque parapsoriasis manifests as faint erythematous patches with arcuate geographic borders. Each lesion often is greater than 6 cm in diameter. Lesions are scattered on the proximal extremities and the trunk and often show a bathing-suit distribution. Surfaces of the lesions have a faint red-to-salmon color; show flaky thin scales; and have an atrophic, cigarette-paper or tissue-paper, wrinkling quality. (See the image below.)

Large plaque parapsoriasis. Large plaque parapsoriasis.
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