A Rare Case of Unilateral Psoriasis with Verruca Vulgaris: Challenges in Diagnosis and Treatment

Marsha Bianti, Shannaz Nadia Yusharyahya, Sondang P. Sirait, Eyleny Meisyah Fitri, Endi Novianto

2019

Abstract

Unilateral psoriasis is a rare clinical variant of plaque psoriasis with unclear pathogenesis. We report a 51-year old woman with a 5-year history of itchy, red, scaly patches on the unilateral right breast, arm, and leg. There were also some vegetating masses on top of the red patches on her lower right leg. Physical examination revealed multiple erythematous plaques with coarse-white scales overlying it, distributed along Blaschko lines on her right side of the body and multiple verrucous nodules on erythematous plaques on her lateral aspect of lower right leg. Histopathology examination showed epidermal psoriasiform hyperplasia and collections of neutrophils. Numerous koilocytes were also seen. Qualitative Human Papillomavirus (HPV) genotyping test was done on lesion on the leg and the result was positive. The diagnosis of unilateral psoriasis with verruca vulgaris was made based onclinico-histopathological findings. To date, there is no guideline available for unilateral psoriasis. She was treated with topical steroid and 5% LCD in vaseline album for psoriasis and 30% salicylic acid in vaseline album for verruca vulgaris and reported improvement. In this case, HPV infection occurs simultaneously. Theoretically, psoriasis lesions are resistant to infection. On the other hand, various microorganisms, including viruses, are known to be associated with exacerbations of psoriasis and HPV infection is considered an opportunistic infection.Unilateral psoriasis with verruca vulgaris is a very rare case. Recognition of this unusual clinical picture of psoriasis variant with overlapping verruca vulgaris is necessary to avoid delayed diagnosis and perform prompt treatment.

Paper Citation

in Harvard Style

Bianti M., Yusharyahya S., Sirait S., Fitri E. and Novianto E. (2019). A Rare Case of Unilateral Psoriasis with Verruca Vulgaris: Challenges in Diagnosis and Treatment.In Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI, ISBN 978-989-758-469-5, pages 286-289. DOI: 10.5220/0009986902860289

in Bibtex Style

@conference{ictromi19,
author={Marsha Bianti and Shannaz Nadia Yusharyahya and Sondang P. Sirait and Eyleny Meisyah Fitri and Endi Novianto},
title={A Rare Case of Unilateral Psoriasis with Verruca Vulgaris: Challenges in Diagnosis and Treatment},
booktitle={Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI,},
year={2019},
pages={286-289},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0009986902860289},
isbn={978-989-758-469-5},
}

in EndNote Style

TY - CONF

JO - Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI,
TI - A Rare Case of Unilateral Psoriasis with Verruca Vulgaris: Challenges in Diagnosis and Treatment
SN - 978-989-758-469-5
AU - Bianti M.
AU - Yusharyahya S.
AU - Sirait S.
AU - Fitri E.
AU - Novianto E.
PY - 2019
SP - 286
EP - 289
DO - 10.5220/0009986902860289