A case of hard-to-diagnose Papuloerythroderma of Ofuji in an elderly male

Authors

  • Shannaz Nadia Yusharyahya Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital
  • Farah Asyuri Yasmin Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital
  • Elisabeth Ryan Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital
  • Lili Legiawati Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital
  • Rinadewi Astriningrum Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital
  • Rahadi Rihatmadja Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital

Keywords:

cyclosporine, diagnosis, geriatric, malignancy, papuloerythroderma of Ofuji

Abstract

Papuloerythroderma of Ofuji (PEO) is a rare form of dermatosis, frequently regarded as a diagnosis of exclusion. The clinical manifestation comprises brownish-red flat papules characteristically sparing the skin fold area, giving the tell-tale “deck chair” sign. Despite the distinctive presentation, many PEO cases are relatively difficult to be recognized, owing to the largely nonspecific clinical and histopathologic features. Various conditions, including atopy, infection, medication, and malignancy, especially cutaneous T-cell lymphoma (CTCL), are often associated with the disease. Herein we described an elderly Indonesian male with erythematous plaques on the head and trunk initially diagnosed as psoriasis vulgaris, in whom PEO was established after two months of evaluation. Treatment with oral cyclosporine and methylprednisolone resulted in clinical improvement. This case illustrates that albeit rare, PEO, and more importantly CTCL, need to be ruled out in this particular demographic setting.

References

Torchia D, Miteva M, Hu S, Cohen C, Romanelli P. Papuloerythroderma 2009: two new cases and systematic review of the worldwide literature 25 years after its identification by Ofuji et al. Dermatology. 2010;220(4):311-20.

Van Rhijn B, van Ruth S, Balak D. Deck‐chair sign: unreserved. Clinical and Experimental Dermatology. 2021;46(3):560-1.

Maher AM, Ward CE, Glassman S, Litvinov IV. The importance of excluding cutaneous T-cell lymphomas in patients with a working diagnosis of papuloerythroderma of Ofuji: a case series. Case Rep Dermatol. 2018;10(1):46-54.

Gudjonsson JE, Elder JT. Psoriasis. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick's Dermatology, 9e. New York, NY: McGraw-Hill Education; 2019.

Sontheimer CJ, Costner MI, Sontheimer RD. Lupus Erythematosus. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick's Dermatology, 9e. New York, NY: McGraw-Hill Education; 2019.

Mangold AR, Pittelkow MR. Lichen Planus. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick's Dermatology, 9e. New York, NY: McGraw-Hill Education; 2019.

Wang W-Y, Su Y-C, Lan C-CE, Chiu S-H. Papuloerythroderma of Ofuji as a paraneoplastic phenomenon in a patient with lung cancer. Dermatologica Sinica. 2022;40(3):182-3.

Li S, Yu X, Wang T. Papuloerythroderma of Ofuji. JAMA dermatology. 2020;156(12):1365.

Desai K, Miteva M, Romanelli P. Papuloerythroderma of Ofuji. Clin Dermatol. 2021;39(2):248-55.

Kasai E, Habe K, Matsushima Y, Kondo M, Yamanaka K. Papuloerythroderma of Ofuji associated with sternoclavicular arthritis and successful treatment with cyclosporine. JAAD Case Reports. 2022;27:70-4.

Mufti A, Lytvyn Y, Abduelmula A, Kim P, Sachdeva M, Yeung J. Treatment outcomes in patients with papuloerythroderma of Ofuji: A systematic review. JAAD international. 2021;3:18-22.

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Published

2023-10-12

How to Cite

1.
Yusharyahya SN, Yasmin FA, Ryan E, Legiawati L, Astriningrum R, Rihatmadja R. A case of hard-to-diagnose Papuloerythroderma of Ofuji in an elderly male. J Pak Assoc Dermatol [Internet]. 2023Oct.12 [cited 2024Dec.2];33(4):1744-9. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/2355

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Case Reports

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