PMC9021576_01
Confluent salmon erythema on the back with islands of sparing.
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On examination, she had type II skin with a strikingly symmetrical rash consisting of bright red scaly plaques on the face, torso and limbs, with follicular papules on the dorsal hand and at the advancing edge of the plaques (Figures 1, 2, 3(a)).
Symmetric confluent salmon erythema on the lower limbs with follicular papules at the active, spreading edge.
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On examination, she had type II skin with a strikingly symmetrical rash consisting of bright red scaly plaques on the face, torso and limbs, with follicular papules on the dorsal hand and at the advancing edge of the plaques (Figures 1, 2, 3(a)).
(a) Confluent salmon erythema of the arms with follicular papules on the knuckles. (b) Complete resolution after 3 months' therapy.
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On examination, she had type II skin with a strikingly symmetrical rash consisting of bright red scaly plaques on the face, torso and limbs, with follicular papules on the dorsal hand and at the advancing edge of the plaques (Figures 1, 2, 3(a)). The palmoplantar keratoderma resolved completely (Figures 3(b), 4(b)).
(a) Palmar keratoderma. (b) Complete resolution after 3 months' therapy.
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There was an orange-red waxy palmoplantar keratoderma and nutmeg grater-like follicular papules on the knuckles (Figure 4(a)). The palmoplantar keratoderma resolved completely (Figures 3(b), 4(b)).
Skin histopathology: (a) Irregular psoriasiform hyperplasia, thickened suprapapillary plates and lymphocytic infiltrate in superficial dermis. Hematoxylin and eosin, original magnification x 10. (b) Preserved granular layer with alternating ortho- and parakeratosis. Hematoxylin and eosin, original magnification x 14.
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The skin punch biopsy revealed alternating parakeratosis and orthokeratosis on a vertical and horizontal plane, irregular psoriasiform hyperplasia, thickened papillary dermal plates, preserved granular layer and a perivascular lymphocytic infiltrate in the superficial dermis (Figure 5(a) and (b)).