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Small-Plaque Parapsoriasis

Last updated Jan. 13, 2019

Approved by: Maulik P. Purohit MD MPH

Small-Plaque Parapsoriasis (SPP) is observed as yellowish patches on the skin measuring less than 5 cm. They can be present on the chest or back, and are not usually itchy.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Chronic Superficial Small Plaque Dermatosis
  • Digital Dermatosis
  • SPP (Small-Plaque Parapsoriasis)

What is Small-Plaque Parapsoriasis? (Definition/Background Information)

  • Plaque parapsoriasis is a skin condition that resembles psoriasis. It is caused by an abnormal inflammation of the skin. The skin lesions appear as scaly patches and plaques
  • It is a rare condition that occurs worldwide. There are two types of plaque parapsoriasis:
    • Small-Plaque Parapsoriasis
    • Large-Plaque Parapsoriasis
  • Small-Plaque Parapsoriasis (SPP) is observed as yellowish patches on the skin measuring less than 5 cm. They can be present on the chest or back, and are not usually itchy
  • In general, individuals in the 30-60 year age group are affected the most. There is a male predilection for Small-Plaque Parapsoriasis
  • Small-Plaque Parapsoriasis usually does not result in the development of mycoses fungoides, a type of cutaneous T-cell lymphoma. However, in rare cases, SPP can lead to the formation of mycoses fungoides
  • The treatment for the condition in symptomatic individuals may include the use of topical steroidal creams and moisturizers and photo-chemotherapy. The prognosis of Small-Plaque Parapsoriasis is generally good

Who gets Small-Plaque Parapsoriasis? (Age and Sex Distribution)

  • Small-Plaque Parapsoriasis is a rare skin condition that is typically seen in middle-aged to older adults in the age group of 30-60 years
  • It can affect both males and females, although males are affected more than females in a 3:1 ratio
  • In general, SPP occurs worldwide and individuals of all racial and ethnic background may be affected

What are the Risk Factors for Small-Plaque Parapsoriasis? (Predisposing Factors)

  • The risk factors for Small-Plaque Parapsoriasis are currently unknown or unidentified

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Small-Plaque Parapsoriasis? (Etiology)

  • The exact cause of development of Small-Plaque Parapsoriasis involving the skin is unknown
  • It is the result of skin inflammation that takes place due to as yet unascertained reasons
  • SPP is non-contagious and is not transmitted from one individual to another; one cannot contract the condition through close physical interaction with the affected individuals

What are the Signs and Symptoms of Small-Plaque Parapsoriasis?

Small-Plaque Parapsoriasis develops slowly over a long period of time, usually months and years. The signs and symptoms of the condition may include:

  • The skin lesions are slow-growing and appear as yellow patches with plaque formation
  • The affected skin looks wrinkled and white flaky scales can be present on it
  • The patches can be seen on the chest, back (trunk), or buttocks
  • Itching sensation is usually absent
  • Sometimes, linear finger-like shape is observed; the skin lesions appear as finger impression from a hug or slap on the back. Thus, some healthcare providers call this condition as Digital Dermatosis
  • The size of the lesion is usually less than 5 cm

How is Small-Plaque Parapsoriasis Diagnosed?

The following are the diagnostic methods and tests that may be used for Small-Plaque Parapsoriasis:

  • A thorough physical examination and a complete medical history are very crucial. A diagnosis of SPP may be arrived at clinically by analyzing the presentations. A skin biopsy may not be necessary in many cases, but can be performed to exclude other conditions
  • Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
  • Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
  • Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A skin biopsy is performed to rule out other similar conditions
  • A differential diagnosis may be considered to eliminate the following conditions:
    • Allergic contact dermatitis
    • Drug reaction
    • Fungal infection of skin

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Small-Plaque Parapsoriasis?

The complications of Small-Plaque Parapsoriasis may include:

  • In some individuals, the condition may present cosmetic issues
  • The lesions may periodically appear and disappear and this can last for years resulting in self-image issues, emotional stress, and psychological trauma in some individuals
  • In a small number of cases, SPP can result in mycoses fungoides, a type of T-cell lymphoma of the skin

How is Small-Plaque Parapsoriasis Treated?

In a majority of individuals, no treatment may be required. For those with significant signs and symptoms, the treatment strategies that may be adopted in the management of Small-Plaque Parapsoriasis include:

  • Use of topical steroidal creams and lotions in severe cases
  • Phototherapy
  • Photochemotherapy when the response to medications is poor
  • Surgical excision with skin grafts may be required in some cases
  • Providing reassurance and helping with feelings of stress and anxiety

Follow-up care with regular screening and checkups are important, since the condition can recur and last for many months and years.

A few self-care tips and home remedies for SPP may include:

  • Completely avoid scratching the affected areas
  • A comfortable, cool bath may help soothe the skin; but, avoid excessive washing and scrubbing of the skin
  • Wear smooth cotton clothes
  • Use only mild perfumes, soaps, and detergents
  • Drinking lots of water or fluids

How can Small-Plaque Parapsoriasis be Prevented?

  • Currently, there are no specific methods or guidelines to prevent Small-Plaque Parapsoriasis
  • A careful and periodic monitoring (and follow-up) of the condition is highly recommended

What is the Prognosis of Small-Plaque Parapsoriasis? (Outcomes/Resolutions)

  • Small-Plaque Parapsoriasis may not cause significant symptoms in some individuals. Such individuals may not require any treatment; providing reassurance (if there are emotional issues) and maintaining periodic observance may be sufficient treatment
  • In some individuals, the symptoms may appear, subside, and then recur with time
  • Nevertheless, individuals with milder signs and symptoms have a better prognosis than those with severe signs and symptoms
  • Regular follow up visits with the healthcare providers are important

Additional and Relevant Useful Information for Small-Plaque Parapsoriasis:

  • Some researchers believe that Small-Plaque Parapsoriasis and Large-Plaque Parapsoriasis are related to each other, while others say that these are two different disease processes
  • There is no definitive proof that certain types of diet play a role in the development of this skin condition
  • Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
  • The presence of dirt on the body does not cause the condition. However, it helps to be clean and hygienic, which will help the condition from getting worse

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Jan. 15, 2016
Last updated: Jan. 13, 2019