Rowawi Rasmia, Dwipangestu Gilang, Suwarsa Oki, Dharmadji Hartati Purbo, Sutedja Endang, Pangastuti Miranti, Gunawan Hendra
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung 40161, Indonesia.
Psoriasis (Auckl). 2020 Dec 30;10:61-66. doi: 10.2147/PTT.S285832. eCollection 2020.
Psoriasis may manifest as severe hyperkeratotic lesions resembling an oyster shell called ostraceous psoriasis (OP). This type of psoriasis is extremely rare and is often associated with psoriatic arthritis (PA). Cases of OP associated with PA in children have never been reported before. We reported a 9-year-old girl with hyperkeratotic lesions resembling an oyster shell all over the body accompanied with swelling on joints of both fingers, knee joints, and ankle. Histopathological examination supported the diagnosis of OP. The diagnosis of PA was established according to the Classification Criteria for Psoriatic Arthritis (CASPAR). Significant improvements of the skin lesions and joints involved were observed within 44 days after the beginning of treatment with cyclosporine and a combination of high potent topical steroid with emollient. OP associated with PA is uncommonly seen in children. High potent corticosteroid combined with emollient showed good result in skin improvement with low side effects. In addition, cyclosporine can be a good choice of systemic therapy for OP with PA in children.
银屑病可能表现为严重的角化过度性皮损，类似牡蛎壳，称为蛎壳状银屑病（OP）。这种类型的银屑病极为罕见，且常与银屑病关节炎（PA）相关。此前从未有儿童PA合并OP的病例报道。我们报告了一名9岁女孩，全身出现类似牡蛎壳的角化过度性皮损，同时双手手指关节、膝关节和踝关节肿胀。组织病理学检查支持OP的诊断。根据银屑病关节炎分类标准（CASPAR）确立了PA的诊断。在开始使用环孢素以及强效外用类固醇与润肤剂联合治疗后的44天内，观察到皮肤病变和受累关节有显著改善。儿童中PA合并OP并不常见。强效皮质类固醇与润肤剂联合使用对皮肤改善效果良好且副作用低。此外，环孢素对于儿童PA合并OP可能是一种不错的全身治疗选择。
