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There are some diseases that are clearly inflammatory and others that are clearly neoplastic. Parapsoriasis exists in the middle of the spectrum. Sometimes it is hard to determine if it is inflammatory or neoplastic, but in general SPP is considered inflammatory and LPP is considered closer to neoplastic.
SPP (small plaque parapsoriasis)
| • | less than 5cm, fine adherent scale, macules and patches |
| • | especially trunk, sparing face, anterior surfaces, palms and soles |
| • | a distinctive variant = “digitate dermatosis”: ellipsoid, tan macules, on trunk the shape of fingers pressed against skin |
| • | often resistant to treatment |
| • | "PR that lingers is small plaque parapsoriasis" - Dr. Fisher |
LPP (large plaque parapsoriasis)
| • | broad irregularly shaped, elevated patches or plaques |
| • | usually greater than 5cm and often >10cm |
| • | buttocks, thighs, flexural surfaces, and breasts |
Parapsoriasis Variegata = poikilodermatous MF (now more frequently called "poikiloderma vasculare atrophicans"
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