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February 1968


Arch Dermatol. 1968;97(2):230-232. doi:10.1001/archderm.1968.01610080134021

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Psoriasis and Parapsoriasis. Presented by Dr. Perry Sachs. 

History.—  In 1963 this 68-year-old white man developed an erythematous scaly eruption on the extremities which was considered an allergic dermatitis at that time. In 1966 typical psoriatic lesions were noted on the elbows and knees. Treatment was initiated with fluocinolone acetonide (Synalar) cream 0.025%.On Feb 7, 1967 beside the typical psoriatic lesion, there were also well-defined reddish-brown lesions of varying and irregular shapes distributed over the lower trunk and thighs. Two biopsies were taken. One from the elbow and one from the thighs.

Histopathology.—  Histopathology revealed parakeratosis and moderate acanthosis; suprapapillary thinning of the epidermis. The subepidermal areas are edematous and infiltrated with mononuclear cells. The parakeratotic layer contains nuclear fragments, but no Munro microabscesses. There is no liquefaction degeneration of the basal layer.

Diagnosis.—  Psoriasis.Within the upper cutis there are dilated blood vessels, edema, and moderate focal and

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