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Dermatology · Papulosquamous: large plaque parapsoriasis
Sample itemA 55-year-old man has persistent, slightly atrophic, fine-wrinkled patches over 10 cm on the buttocks and thighs for years. What is the clinical concern?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. It may progress to mycosis fungoides, so serial biopsies are advised
Large plaque parapsoriasis, with patches over 5 cm and atrophic wrinkled surface, is regarded as an early patch stage of cutaneous T-cell lymphoma in many cases. Persistent or changing lesions warrant rebiopsy. Small plaque parapsoriasis is typically benign.
Option by option
A. It may progress to mycosis fungoides, so serial biopsies are advised (correct)
Correct. Large plaque disease can evolve to mycosis fungoides.
B. It confers a risk of melanoma
Melanoma risk is not increased in parapsoriasis.
C. It is a precursor to basal cell carcinoma
Basal cell carcinoma is not linked to parapsoriasis.
D. It will transform into pemphigus
Pemphigus is an autoimmune blistering disease unrelated to parapsoriasis.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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