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KMID : 1149120180150010026
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Journal of the Korean Society for Psoriasis
2018 Volume.15 No. 1 p.26 ~ p.28
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A Case of Recurrent Lapiere-type Psoriasis (Annular pustular psoriasis) Recalcitrant to Biologics
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Kim Chong-Gue
Bae In-Ho
Kim Min-Sung
Choi Hoon
Na Chan-Ho
Shin Bong-Seok
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Abstract
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Lapiere-type psoriasis (annular pustular psoriasis) is characterized by erythematous, annular form plaques and pustules on a ring-like erythema. A 63-year-old man presented with asymptomatic multiple various sized scaly plaques on whole body. He diagnosed with psoriasis vulgaris 30 years previously and also had diabetes and hypertension. He had intermittent annular erosiove lesions while plaque lesions were repeatedly improved and aggravated. He has been treated with oral cyclosporin, sulfasalazine, antihistamine and topical steroid for 1 year. But there was not significant improvement in skin lesions. So, we decided to treat with ustekinumab monotherapy. However, recurrence of the plaques and annular lesions were still present after the ustekinumab injection six times, so we switched to secukinumab monotherapy. After that, the lesions of plaque type psoriasis were improved, but the annular eruptions still had intermittent recurrence. Biopsy was taken from the lesion and showed hyperkeratosis, subcorneal pustule and spongiform pustule of Kogoj, and perivascular lymphocytic infiltration. Based on clinical and histopathologic features, recurrent Lapiere-type psoriasis recalcitrant to biologics was diagnosed.
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KEYWORD
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Annular pustular psoriasis , Lapiere-type psoriasis
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