Answer:
Dear
Anu,
Parapsoriasis
can progress to coetaneous T-cell lymphoma (CTCL) skin cancer if left
untreated or treated inadequately.
Parapsoriasis
can last a few weeks to several years or even a lifetime.
Parapsoriasis
can be managed conservatively, based on symptoms. Often, topical treatment
is effective
* Small
plaque parapsoriasis usually is asymptomatic. Treatment should be
based on alleviation of symptoms associated with scaliness. Patients
should be reassured of the benign self-limiting nature of the disease.
-o- Emollients
may be sufficient to treat scaliness; however, a trial of midpotency
topical steroids (class 3-5) may lead to greater clinical responsiveness.
-o- Phototherapy
is effective in treating lesions that are widely scattered. Broad-
or narrow-band UV-B can be effective and can lead to remission.9,10
More recalcitrant presentations can be treated with psoralen and long-wave
ultraviolet radiation (PUVA).
-o- Annual
follow-up is recommended. An increase in the number of lesions, an
increase in the size of lesions, or the development of induration
or epidermal atrophy should prompt a repeat biopsy to consider a diagnosis
ofMF
in evolution.
* Large
plaque parapsoriasis should be treated because this may prevent progression
to MF (CTCL).
-o- Therapy
includes mid- to high-potency topical steroids (class 2-4), topical
nitrogen mustard, and topical carmustine (BCNU).
-o- Phototherapy
with either broad- or narrow-band UV-B or PUVA can be effective in
inducing remission.
-o- Follow-up
every 6 months is recommended. Increasing number of lesions, increase
in lesion size, or the development of induration or epidermal atrophy
should prompt a repeat biopsy to consider a diagnosis of MF in evolution.
Pregnancy
appeared to have no impact on the course of parapsoriasis en plaque,
and no adverse effect was noted on pregnancy. Further studies are
needed to clarify the interplay between pregnancy and parapsoriasis
en plaque.
The effect
of parapsoriasis on pregnancy, is still unknown.
Triamcinolone
(Aristocort), a midpotency steroid formulation used to treat Parapsoriasis
has fetal risk revealed in studies in animals but not established
or not studied in humans; may use if benefits outweigh risk to fetus.
