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Parapsoriasis (Pityriasis Lichenoides Chronica, Juliusberg). Presented by Dr. Max Popper.
Dr. Eliot Wolk: I noted that the nails were pretty well pitted, that point suggesting psoriasis. I should like to ask the presenter about that observation and its relationship to the diagnosis.Dr. Max Popper: I have observed the patient only a few weeks. This type of parapsoriasis resembles psoriasis. However, the following differential diagnostic distinctions can be made:In psoriasis the scales are silvery white while in pityriasis lichenoides chronica they are yellowish white. Accordingly, in psoriasis the hyperkeratosis is pronounced while in pityriasis lichenoides chronica it is only moderate.The scales in psoriasis can frequently be lifted as a thin film, while in pityriasis lichenoides chronica the scales are flaky. Accordingly, in psoriasis we find a uniform parakeratotic layer which tends to maintain the cohesion among the keratotic cells while in pityriasis lichenoides chronica parakeratosis is
Alcon DN, Fishman HC. METROPOLITAN DERMATOLOGICAL SOCIETY OF LOS ANGELES. AMA Arch Derm Syphilol. 1951;64(1):75–77. doi:10.1001/archderm.1951.01570070078020
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