engleski

A RARE CASE OF FOLLICULAR PSORIASIS SUCCESSFULLY TREATED WITH NARROW-BAND ULTRAVIOLET B PHOTOTHERAPY

Background: Psoriasis is a common, chronic, T-cell mediated, hyperproliferative dermatosis presenting as many clinical variants. Follicular psoriasis is well documented but the least well- characterized clinical variant of psoriasis that might develop alone or in association with other types of psoriasis. It can be misdiagnosed as a condition such as pityriasis rubra pilaris, lichen spinulosus, lichen planopilaris, follicular eczema, papular pityriasis rosea, papular secondary syphilis, perforating dermatoses, and acute suppurative folliculitis. Aim: Our aim in presenting this case report is to promote awareness of follicular psoriasis as a disease entity. Case report: An otherwise healthy 18-year- old girl presented in our Department with a one- year history of pruritic, multiple disseminated whitish follicular, hyperkeratotic, papules on the lower legs, thighs, buttocks, extensor aspects of the forearms and upper arms, lateral aspects of the abdomen, and on the lumbosacral region along with discrete pityriasiform desquamation. Also, she have had erythema and desquamation of the scalp for four years. She had been followed up by a local dermatologist and had been treated with topical corticosteroids and keratolytic agents with a partial therapeutic response. Her grandmother was suffering from vulgar type of psoriasis for many years. The skin biopsy had been done a month before and came with the diagnosis of eczematous dermatitis. We repeated the biopsy from a nuchal region that demonstrated involvement of the follicular infundibula and parakeratosis in the ostium which was consistent with a follicular type of psoriasis. The patient was treated with narrow-band ultraviolet-B (nbUVB) phototherapy in 20 expositions which resulted in the resolution of the skin lesions. Conclusion: Follicular psoriasis is under-recognised or misdiagnosed condition that develops alone or in association with the other variants of psoriasis, especially of the scalp as seen in our patient. We showed that follicular type could also be successfully treated with nbUVB phototherapy as the most clinical variants of psoriasis. Long- term follow-up is needed to evaluate the course of this rare subtype of psoriasis.

PSORIASIS ; FOLLICULAR ; NBUVB

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