Parapsoriasis
Abstract
Parapsoriasis is a dermatological term for a group of chronic erythematosquamous skin disorders, which share their clinical features and possibility of progression to cutaneous T-cell lymphoma. Classification and terminology of parapasoriasis in the literature is not uniform. The term parapsoriasis in its narrower sense includes two conditions, small plaque parapsoriasis and large plaque parapsoriasis. The etiopathogenesis of this disease is not explained sufficiently. Recently, the concept of clonal dermatitis has been proposed, which defines parapsoriasis as a benign lymphoproliferative disorder with proliferation of CD4+ T-cells. Parapsoriasis is considered as a transitional step between chronic dermatitis with polyclonal lymphocyte infiltrate and cutaneous T-cell lymphoma. In small patch parapsoriasis, tendency of progression to cutaneous T-cell lymphoma is low but can occur in at least 10% of patients with large patch parapsoriasis within a decade.
Establishing the correct diagnosis requires thorough correlation of clinical features and histopathological skin examination. Immunophenotype of lymphocytes and determination of their clonality with molecular biological methods can help in distinguishing parapsoriasis from cutaneous T-cell lymphoma. For therapy of parapsoriasis, topical corticosteroids and phototherapy are usually sufficient. The key factor in an approach to parapsoriasis is regular follow-up of patients to assess the risk of progression to cutaneous T-cell lymphoma. In the article, current aspects on parapsoriasis and recommendations for management of patients are presented.
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