Studija slučaja
https://doi.org/10.21857/mwo1vc462y
Plaque psoriasis in Fitzpatrick skin phototype V successfully treated with acitretin: a case report
Mislav Mokos
Katarina Dragun
Filip Bosnić
Iva Blajić
Mirna Šitum
Sažetak
Psoriasis is a chronic immune-mediated skin disease that most commonly presents as erythematous, scaly plaques. In individuals with darker skin phototypes, erythema may be less apparent and postinflammatory pigmentary changes are more pronounced, which can complicate both diagnosis and assessment of disease severity. Dermoscopy can help visualise vascular and scaling patterns that are macroscopically difficult to recognise during clinical examination. A 37-year-old man from Bangladesh with Fitzpatrick phototype V presented with a two-year history of plaque psoriasis, initially confined to the lower legs and later generalised to the trunk and upper extremities. At first evaluation in September 2024, his Psoriasis Area and Severity Index (PASI) was 10, body surface area (BSA) 10% and Dermatology Life Quality Index (DLQI) 8. Dermoscopy of representative plaques revealed a light red background with regularly distributed dotted vessels and diffuse white scales, a pattern highly suggestive of psoriasis. Oral methotrexate (15 mg weekly) with folic acid and topical therapy initially led to partial improvement (PASI 4, BSA 10%, DLQI 5), followed by a flare (PASI 15, BSA 20%, DLQI 10). Methotrexate was discontinued and acitretin 25 mg daily was introduced. After approximately three months of acitretin therapy, complete clearance was achieved (PASI 100) without adverse effects or laboratory abnormalities. This case highlights the diagnostic and monitoring challenges of psoriasis in darker skin, the added value of dermoscopy in confirming the diagnosis, and the continued relevance of acitretin as an effective non-immunosuppressive systemic option in carefully selected patients.
Ključne riječi
psoriasis; acitretin; skin of colour; dermoscopy; phototype V
Hrčak ID:
346152
URI
Datum izdavanja:
28.12.2025.
Posjeta: 266 *