Ostraceous Psoriasis, An Unusual Presentation: Case Report

Authors

  • Arausi Tortolero González First year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo Ciudad Hospitalaria “Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela Author
  • Liliana Coromoto Rosales Ochoa Third year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo Ciudad Hospitalaria “Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela Author
  • Katherine Joleidy Mejía Second year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo Ciudad Hospitalaria “Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela Author
  • Marcia Endara V Dermatology Specialist. Faculty Member, University of Carabobo. Member of the Coordinating Committee of the Postgraduate Program in Dermatology, University of Carabobo. Consultant, Dermatology Service, Ciudad Hospitalaria “Dr. Enrique Tejera.” Author

DOI:

https://doi.org/10.47363/JDMRS/2026(6)185

Keywords:

Ostraceous Psoriasis, Plaque Psoriasis, Hyperkeratosis

Abstract

ABSTRACT
We report the case of a 16 year old female patient, Fitzpatrick skin phototype IV, who presented with a generalized, bilateral, and symmetrical dermatosischaracterized by erythematous plaques of oval configuration with well defined regular borders. The lesions exhibited whitish, hyperkeratotic, concavescales resembling oyster shells on their surface, with variable distribution and size, pruritic in nature, and of two months’ evolution. Histopathologicalexamination was consistent with psoriasis vulgaris. Systemic therapy with methotrexate was initiated, combined with high potency topical corticosteroids(clobetasol cream 0.05%), achieving satisfactory clinical improvement after three months of treatment. Ostraceous psoriasis is an uncommon presentation,with few cases reported in the literature. It accounts for approximately 26% of the atypical hyperkeratotic variants of plaque psoriasis. The diagnostichallmark lies in the recognition of the elementary lesion: plaques with an erythematous ring and infiltrated base, circular in configuration, with regular
and well defined borders, and an internal concave, concentric, and conical surface that imparts the characteristic oyster shell appearance. Therapeutic
management is generally based on conventional systemic and topical regimens; however, in refractory cases, biological therapy has been employedwith favorable outcomes.

Author Biographies

  • Arausi Tortolero González, First year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo Ciudad Hospitalaria “Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela

    Arausi Geraldine Tortolero, First year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo – Ciudad Hospitalaria“Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela. 

  • Liliana Coromoto Rosales Ochoa, Third year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo Ciudad Hospitalaria “Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela

    Third year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo Ciudad Hospitalaria “Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela

  • Katherine Joleidy Mejía, Second year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo Ciudad Hospitalaria “Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela

    Second year Dermatology Resident, Postgraduate Program in Dermatology, University of Carabobo Ciudad Hospitalaria “Dr. Enrique Tejera,” Valencia, Carabobo State, Venezuela

  • Marcia Endara V, Dermatology Specialist. Faculty Member, University of Carabobo. Member of the Coordinating Committee of the Postgraduate Program in Dermatology, University of Carabobo. Consultant, Dermatology Service, Ciudad Hospitalaria “Dr. Enrique Tejera.”

    Dermatology Specialist. Faculty Member, University of Carabobo. Member of the Coordinating Committee of the Postgraduate Program in Dermatology, University of Carabobo. Consultant, Dermatology Service, Ciudad Hospitalaria “Dr. Enrique Tejera.” 

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Published

2026-01-12

Issue

Vol. 7 No. 1 (2026): Voulume 7 Issue 1

Section

Articles