PSORIASIS, INVERSE TYPE
By Gary M. White, MD
Psoriasis commonly affects the body folds, e.g. axilla, inframammary area, gluteal cleft and groin. The term inverse psoriasis is used.
The typical ham-colored plaques are present, but without scale because of the moist, occluded location. Look for typical signs of psoriasis elsewhere.
The TCIs are good here, to prevent atrophy, e.g. pimecrolimus cream BID. Alternatively, a low to medium potency topical steroid cream may be employed, but watch for atrophy or striae.
Dovonex was successfully used in the majority of patients without significant irritation [BJD 1996;135;647]. When used in the folds, it is best given as a cream once a day.
The gluteal cleft and the axilla.
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