Takagi Dermatological Clinic, Nishi 3 Minami 4-16, Obihiro, Hokkaido 0800013, Japan
Received: 09 September, 2016; Accepted: 23 September, 2016; Published: 24 September, 2016
Hidetoshi Takahashi, Takagi Dermatological Clinic, Nishi 3 minami 4-16, Obihiro, Hokkaido 0800013, Japan, Tel : +81-155-25-6733; Fax: +81-155-25-0308; E-Mail:
Takahashi H (2016) A Japanese Case of Nonpustular Annular Psoriasis. Int J Dermatol Clin Res 2(1): 019-020. DOI: 10.17352/2455-8605.000017
© 2016 Takahashi H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Annular psoriasis; Japanese; Nonpustular; Pustular psoriasis; Treatment
Nonpustular annular psoriasis is a rare form of psoriasis with clinically annular ring-shaped configuration. In contrast to recurrent circinate erythematous psoriasis, which is the mildest form of pustular psoriasis, no evidence of histopathological Kogoi’s spongiform pustule formation is detected. We report a case of 57-year-old Japanese woman with nonpustular annular psoriasis for 4 year.
Nonpustular annular psoriasis is a rare form of psoriasis with clinically annular ring-shaped configuration . In contrast to recurrent circinate erythematous psoriasis (Psoriasis a type d’erytheme circine recidivant de Bloch) , which is the mildest form of pustular psoriasis, no evidence of histopathological Kogoi’s spongiform pustule formation is detected.
Results and Discussion
A 57-year-old Japanese woman had a 4-year history of annular erythematous plaques on her four extremities (Figure 1a). She denied either pustule or vesicle formation during the course. Physical examination revealed slightly elevated 5-10cm-sized annular erythematous plaques accompanied with small lamellar scales without pustules. There were no typical non-annular plaque lesions of psoriasis. The annular lesions had been improved by corticosteroid and active vitamin D3 ointments. She had no family history of psoriasis or specific drug intake. Skin biopsies were taken from the infiltrative edge of annular lesions on her extremities. Histopathology showed typical features of psoriasis (Figure 1b), but no evidence of Kogoj’s spongiform pustule was detected. Furthermore, the histopathological examination of sections from 3 skin biopsies did not show any infiltration of neutrophils. There was no coat-sleeve-like perivascular cuffing of mononuclear cell infiltration. Laboratory study including full blood cell count and biochemical investigation were normal except for moderate increase in cholesterol and triglyceride level. Serum tests for syphilis, rheumatoid factor, anti-nuclear antibody, SS-A, SS-B, antibodies, HBs antigen and HCV were all negative or within normal limits. KOH preparation was negative for fungal infection. The patient was treated with daily application of triamcinolone acetomide 0.1% and maxacalcitol (25 µg/g) ointments. Her skin lesions gradually improved and no new lesions were observed during the last 6 months. The patient was diagnosed as nonpustular annular psoriasis.
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