Psoriasis with a dirt-adherent: A rare case report.

Cutaneous dirt-adherent disease (CDAD) is a rare psychogenic dermatosis mainly occurring in young Japanese and Chinese women. It mainly occurs on cheeks, forehead, nipple, mammary areola and around mammary areola. To our knowledge, this is the first case of CDAD with the skin lesion of psoriasis rupioides to be reported. In our case, the patient, a 43-year-old Chinese man presented with thick, yellowish-brown adherent crusts on his face with severe painful 6-days duration. Histopathologic image: Parakeratosis, the epidermis demonstrates regular acanthosis with some thinning of the suprapapillary plates, neutrophils exocytosis are noted. As for the histopathologic diagnosis in his right crus, combined with the clinical manifestation of rupioides-shaped crusts, film phenomenon and Auspitz's sign, we considered Psoriasis rupioide.