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Follicular Psoriasis- Is this a true entity?


Sasi Attili

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I came across [url="http://onlinelibrary.wiley.com/doi/10.1111/cup.12221/abstract"]this cover quizlet[/url] in the recent edition of the JCP and was debating as to what I would have called this!

The authors called this Follicular Psoriasis on the basis of the histology which showed follicular plugging with abundant parakeratotic keratin and neutrophils. The infundibular epithelium showed mild hyperplasia and minimal spongiosis. The perifollicular epidermis showed mild psoriasiform hyperplasia, while the rest of the epidermis was unremarkable. Stains for organisms and trichrome stains (to rule out perforating disorders) were negative.

I have an issue with this diagnosis as the patient does not have either classic plaque psoriasis or a family history of the same. So in the absence of a supporting history how can one be sure that this is a variant of psoriasis, just because there is parakeratosis with neutrophils?

Has anyone else come across this variant?

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