Generalized Ostraceous Psoriasis

This is an answer to the Case – Sharply Demarcated, Erythematous, Plaques Covered with Scales and Crust

A 47-year-old woman presented with a 2-week history of widespread, painful lesions on her trunk and limbs. Her medical history included hypercholesterolemia, diabetes, and a 10-year history of psoriasis that had been treated with corticosteroids, calcipotriene, and methotrexate.

Five months before presentation, the patient’s psoriasis went into remission, and treatment was discontinued. Physical examination revealed sharply demarcated, erythematous, well-defined limpetlike plaques covered with scales and crust. Laboratory testing revealed hyperglycemia and hypercholesterolemia.

A diagnosis of ostraceous psoriasis was made. The patient was treated with topical petrolatum containing 20% salicylic acid and mometasone furoate cream, resulting in improvement of the lesions after 3 weeks. Adalimumab was then added, with complete resolution of the lesions after an additional 14 weeks.