A 55-year-old woman with strong family history of psoriasis presented with many well-demarcated, red plaques covered with white silvery scales on the lower limbs and trunk. She claimed exacerbation of her lesions on psychological upsets.
Lichen planus actinicus is not uncommonly seen in children. A 10-year-old boy presented with few annular plaques with hyperpigmentd centers and pinkish-violaceous borders of 3 months duration. All lesions are confined to sun-exposed sites (face, chest and forearms).
The dorsal surface of the tongue is smooth, glistening and whitish with few surface fissures. Other parts of the oral cavity are normal. Skin, hair and nails were negative. VDRL and TPHA were non-reactive. Great relief from pain on eating and even on talking on intralesional triamcenolne infiltration (5 mg per ml) given every 3-4 months. Topical CS in orabase was not effective.
A 30-year-old male presented with asymtomatic, well-marginated, red scaly plaques involved the upper inner thighs and hands of many years duration. The plaques on the hands produced keratoderma with fissuring of the palms. Most topical anti-psoriatic therapies failed to produce significant improvement. Shifting the patient to Acitretin 25 mg per day yielded excellent response in thigh lesions and satisfactory improvement of palmar lesions.
A 30-year-old man who is a known case of plaque psoriasis since 8 years presented with many classical well-demarcated red scaly plaques mainly on the extremities with minimal trunk involvement. Psoriatic plaques may take different shapes and sizes. Some lesions may be described as map-like, the presented lesion was on the shin and may be an example of such shape.
A middle-aged woman has suffered a slightly pruritic but cosmetically bothering hyperpigmented slightly scaly rash confined to photosensitive areas of the face and dorsa of the hands of two years duration. The rash is persistent through out the year but usually exacerbates during spring and early summer. The color of the rash was characteristically pinkish-purplish on the face and more darkly pigmented and shiny on the hands.
Usually psoriasis presents as bilateral symmetrical fiery-red or salmon pink well-demarcated plaques covered with large thick white silvery scales. However, occasionally some of these features may be missed as in this 32-year-old male who presented with unilateral leg involvement but all other characteristic features are well seen.