Recalcitrant psoriasiform dermatosis of the face: Is it related to pityriasis rubra pilaris?

Abstract

This recalcitrant psoriasiform facial dermatosis seems to be a distinct entity, with consistent and reproducible clinical features and a PRP-like histology, bearing some resemblance to the recently described condition-facial discoid dermatosis.

Persistent facial discoid dermatosis successfully treated with topical calcipotriol

“…It can be resistant to numerous treatments. 3,4 . To our knowledge, there is only one case report similar to ours describing successful treatment of FDD with a combination of topical calcipotriol/betamethasone ointment alongside low‐dose acitretin 2 .…”

“…FDD is a rare, perhaps under-recognized, perhaps misdiagnosed condition. It can be resistant to numerous treatments.. 3,4 To our knowledge, there is only one case report similar to ours describing successful treatment of FDD with a combination of topical calcipotriol/betamethasone ointment alongside low-dose acitretin. 2 Interestingly, our patient experienced significant improvement without the need for an oral retinoid and despite cessation of the topical steroid early in treatment.…”

Facial discoid dermatosis: A cosmetically disfiguring and challenging condition to treat

“…[1][2][3][4] In the largest case series of eight patients, additional histological features of subcorneal acantholysis and checkerboard alternating orthokeratosis and parakeratosis were seen. 2 The authors, therefore, postulate that FDD may be a new variant of pityriasis rubra pilaris. One of these cases went on to develop Type 2 pityriasis rubra pilaris.…”

Atrophy of sebaceous lobules in facial discoid dermatosis: a link to psoriasis and seborrheic dermatitis?

“…Facial discoid dermatosis (FDD) is an underrecognized disease characterized by an asymptomatic papulosquamous eruption involving the face. The disorder often persists for several years with minimal progression and is recalcitrant to numerous treatment modalities 1‐4 . The initial differential diagnosis generally includes tinea faciei, psoriasis, seborrheic dermatitis, cutaneous lupus erythematosus, or granuloma faciale.…”

“…The initial differential diagnosis generally includes tinea faciei, psoriasis, seborrheic dermatitis, cutaneous lupus erythematosus, or granuloma faciale. The most common histopathologic features described include focal parakeratosis, follicular plugging, and psoriasiform hyperplasia 1‐4 . Because of the focal parakeratosis and follicular plugging, it has been proposed that FDD may be a localized variant of pityriasis rubra pilaris (PRP) 1,2 .…”