Follicular psoriasis

Abstract

This is a report on ten patients with follicular psoriasis. Two distinct clinical types could be distinguished. An adult form, seen especially in women, presented with widespread psoriasis in which follicular lesions occurred on both thighs as part of the efflorescence. Follicular lesions were aggregated to form isolated asymmetrical plaques on the trunks of children with inactive psoriasis. The histological findings in follicular psoriasis varied according to the age of the lesion. In the early lesion there was a marked dermal infiltrate in which the mast cells were prominent but the hair follicle appeared normal. Older lesions were found to have nucleated cells in the ostium of the follicle. These findings suggest that the hair follicle may be affected as part of psoriatic involvement of the integument.

Follicular Psoriasis: Differentiation from Pityriasis Rubra Pilaris—An Illustrative Case and Review of the Literature

“…Including our case, 13 of 24 (54.2%) patients reported in the literature were female (Table ). In the nine cases in which race was reported, seven (78%) patients were black and one was Asian . Although previous reports have suggested that follicular psoriasis skews toward female and darker‐skinned patients, our review of the literature does not support this.…”

Follicular psoriasis causing erythroderma in a child: A rare presentation

“…The exact incidence is unknown, as we found only three reports mentioning a total of 15 cases in the literature. [478] It affects both the sexes and although two thirds of these occurred in adults, cases have been described in children under the age of 10 years. [7] Lesions follow a chronic course ranging from 6 months to 23 months.…”

“…[8] Two clinical subtypes have been described. [7] The adult form is more common in females, presenting with discrete hyperkeratotic papules usually involving the thighs. [7] The rarer childhood form presents either as grouped, asymmetrical, horny, follicular lesions affecting the trunk, axillae, and bony prominences or as a wide-spread eruption resembling pityriasis rubra pilaris,[78] except that the latter has typical islands of spared skin associated with an orange-red erythema and palmoplantar keratoderma.…”

“…[7] The adult form is more common in females, presenting with discrete hyperkeratotic papules usually involving the thighs. [7] The rarer childhood form presents either as grouped, asymmetrical, horny, follicular lesions affecting the trunk, axillae, and bony prominences or as a wide-spread eruption resembling pityriasis rubra pilaris,[78] except that the latter has typical islands of spared skin associated with an orange-red erythema and palmoplantar keratoderma. There is a pre-disposition among dark-skinned patients and in those with pre-existing plaque type psoriasis,[8] especially of the scalp, though follicular lesions may present without psoriasis vulgaris elsewhere (as occurred in our patient).…”

“…Established lesions show follicular plugging, dilation of the infundibulum and marked ostial parakeratosis with a neutrophilic infiltrate and loss of the granular layer[78] (which is not seen in pityriasis rubra pilaris).…”