Merck Manual

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Shinjita Das

, MD, Harvard Medical School

Last full review/revision Aug 2021| Content last modified Aug 2021
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Topic Resources

Parapsoriasis refers to a group of skin diseases characterized by small and red or scaly patches on the skin.

Parapsoriasis is a disorder that is similar to psoriasis Psoriasis Psoriasis is a chronic, recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin. A problem with the immune... read more Psoriasis . Both disorders cause scaly patches (plaques) to form on the skin. The difference between the two disorders is that in parapsoriasis, the plaques are thinner than they are in the most typical form of psoriasis.

There are two forms of parapsoriasis:

  • Small-plaque form

  • Large-plaque form

Among people with large-plaque parapsoriasis, 10% will develop CTCL every 10 years.

Symptoms of Parapsoriasis

The plaques usually do not cause symptoms. They typically look like thin, scaly, dull, pink patches and may have a slightly wrinkled or thinned appearance.

In the small-plaque form, plaques are less than 2 inches (5 centimeters) in diameter. In the large-plaque form, plaques are greater than 2 inches (5 centimeters) in diameter.

Sometimes the plaques of small-cell parapsoriasis develop on areas of skin served by specific nerves that come out from the spinal cord, especially on the sides of the back and abdomen. These plaques are called digitate plaques because they look like fingers (digits) and can be over 2 inches (5 centimeters) in size. These plaques rarely become CTCL.

Examples of Parapsoriasis

Diagnosis of Parapsoriasis

  • A doctor's evaluation

  • Sometimes skin biopsy

Doctors base the diagnosis of parapsoriasis on how the scales and plaques look and where they appear on the body.

Sometimes, doctors take a sample of skin tissue and examine it under a microscope to rule out other disorders.

Prognosis for Parapsoriasis

The progression of both forms is unpredictable. People undergo periodic follow-ups and biopsies to determine whether they are at risk of developing CTCL.

Treatment of Parapsoriasis

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