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November 2, 1984

Chronic Dermatitis Simulating Small-Plaque Parapsoriasis due to Cyanoacrylate Adhesive Used on Fingernails

Author Affiliations

From the Division of Dermatology, Department of Medicine, Medical College of Ohio, Toledo.

JAMA. 1984;252(17):2455-2456. doi:10.1001/jama.1984.03350170057021

NOTHING blunts a clinician's zest for studying a patient more than recognition of a dermatosis known to be idiopathic. The diagnosis of "parapsoriasis" has such a stultifying effect, having evaded a century of effort to ascertain its etiology. With this report, we hope to engender a more optimistic attitude toward parapsoriasis and encourage more thorough investigation into its possible cause. Our patient with small-plaque parapsoriasis, living under a cloud of clinical pessimism, was found to have a curable problem with an unusual cause.

Report of a Case  A 66-year-old white woman had an 18-month history of a scaly, mildly pruritic eruption that began on her breasts and spread later to the scapular areas, abdomen, and thighs. This had been diagnosed as parapsoriasis en plaques. A skin biopsy specimen taken nine months after the eruption began showed chronic inflammation with epidermal spongiosis, consistent with asteatotic eczema. A second skin biopsy specimen