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Acral psoriasiform hemispherical papulosis, a new entity?

H Ozawa1, T Tadaki, H Tagami

  • 1Department of Dermatology, Tohoku University School of Medicine, Sendai, Japan.

Dermatology (Basel, Switzerland)
|January 1, 1994
PubMed
Summary

A patient with locked-in syndrome developed unusual skin papules on fingers and toes. These rare, psoriasiform lesions on the extremities were not linked to cancer or medications.

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Area of Science:

  • Dermatology
  • Neurology

Background:

  • Locked-in syndrome, a rare neurological condition resulting from brainstem infarction, severely impacts patient mobility and communication.
  • The case involves a 46-year-old patient diagnosed with locked-in syndrome.

Observation:

  • The patient presented with a unique dermatological condition characterized by symmetrically distributed, grouped erythematous cornified hemispherical papules.
  • These distinctive lesions were observed on the fingertips and toes, appearing two years after the initial diagnosis of locked-in syndrome.

Findings:

  • Histopathological examination of the skin lesions revealed psoriasiform changes, a pattern often associated with inflammatory skin conditions.
  • Crucially, the investigation found no evidence of underlying internal malignancy or a history of specific drug intake that could explain the eruption.

Implications:

  • This case report describes a previously undocumented association between locked-in syndrome and a specific type of psoriasiform papule eruption.
  • The findings suggest a potential, albeit uncharacterized, link between neurological damage and cutaneous manifestations, warranting further investigation into pathomechanisms.

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