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Clinical and Therapeutic Aspects of Linear Psoriasis: A Study of 30 Cases

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Abstract

Background

Psoriasis affects 2–4% of the population, with the most common clinical type being plaque psoriasis. The linear form of psoriasis is very rare. The literature on linear psoriasis (LP) consists of only case reports, and data are few.

Objective

This study aimed to better understand LP in a large-scale study.

Patients and Methods

We retrospectively retrieved the medical records from 14 French medical centers of patients newly diagnosed clinically with LP, with or without the support of histology, between 1 February and 31 July 2015. For each case, we assessed the clinical features, treatments and treatment efficacy.

Results

In total, 30 cases of LP (mean age 26.8 years, 13 males) were reported. Mean age at onset of LP was 20.0 years, with 18 developing LP in childhood. Ten patients had a family history of psoriasis, and two had psoriatic arthritis. A total of 19 cases were linear at onset, with concomitant classical psoriasis; these were termed “superimposed” LP. The remaining 11 cases were not associated with classical psoriasis and were termed “isolated” LP. In four of the superimposed cases, LP developed when the patient was receiving systemic treatment: methotrexate (n = 2), etanercept (n = 1) or infliximab (n = 1). Topical steroids were effective in 76% of cases in which they were used, and systemic treatment was effective in < 66%. Treatments were less effective in LP than in classical psoriasis.

Discussion

We identified a wide range of LP, with two profiles: isolated LP and superimposed LP. Topical treatment usually evoked clinical response, with relative resistance to systemic therapy. Methotrexate and anti-tumor necrosis factor (TNF)-α therapies can possibly unmask LP.

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Author information

Authors and Affiliations

  1. Service de Dermatologie, Hôpital Victor Dupouy, 69 rue du Lieutenant-Colonel Prud’hon, 95100, Argenteuil, France

    Matthieu Say & Emmanuel Mahé

  2. Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-Enfants, Bordeaux, France

    Franck Boralévi

  3. Service de Dermatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France

    Cédric Lenormand

  4. Service de Dermatologie, Hôpital Brabois, Vandœuvre Les Nancy, France

    Anne-Claire Bursztejn

  5. Service de Dermatologie, Centre Hospitalier Régional d’Orléans, Orléans, France

    Eric Estève

  6. Service de Pédiatrie, Hôpital Femme-Mère-Enfant, Bron, France

    Alice Phan

  7. Service de Pédiatrie Générale, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France

    Emmanuelle Bourrat

  8. Service de Dermatologie, Hôpital Archet 2, ESPIC CHU-Lenval, Nice, France

    Jean-Philippe Lacour & Christine Chiaverini

  9. Service de Dermatologie, UMR 911 Inserm CRO2, Hôpital Timone, Assistance publique des Hôpitaux de Marseille, Centre de recherche en oncologie biologique et onco-pharmacologie, Université Aix-Marseille, Marseille, France

    Marie-Aleth Richard

  10. Service de Dermatologie, Centre Hospitalier Universitaire de Caen, Université de Caen Basse-Normandie, UFR de Médecine, Caen, France

    Aurélie Acher & Marion Lagaude

  11. Service de Dermatologie, Hôpital Edouard Herriot, University Claude Bernard Lyon-1, Lyon, France

    Denis Jullien

  12. Service de Dermatologie, Centre Hospitalier du Mans, Le Mans, France

    Nathalie Beneton

  13. Service de Dermatologie, Centre Hospitalier Universitaire Bichat-Claude Bernard, Assitance Publique-Hôpitaux de Paris, Paris 7 Diderot University, Paris, France

    Vincent Descamps

  14. Service de Dermatologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes Sorbonne Paris Cité, Paris, France

    Christine Bodemer

Authors
  1. Matthieu Say
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  2. Franck Boralévi
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  3. Cédric Lenormand
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  4. Anne-Claire Bursztejn
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  5. Eric Estève
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  6. Alice Phan
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  7. Emmanuelle Bourrat
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  8. Jean-Philippe Lacour
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  9. Marie-Aleth Richard
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  10. Aurélie Acher
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  11. Denis Jullien
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  12. Nathalie Beneton
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  13. Vincent Descamps
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  14. Christine Bodemer
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  15. Marion Lagaude
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  16. Christine Chiaverini
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  17. Emmanuel Mahé
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Consortia

For the Groupe de Recherche sur le Psoriasis de la Société Française de Dermatologie, and the Groupe de Recherche de la Société Française de Dermatologie Pédiatrique

Corresponding author

Correspondence to Emmanuel Mahé.

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Funding

No sources of funding were used to conduct this study or prepare this manuscript.

Conflicts of interest

MS, FB, CL, A-CB, EE, AP, EB, J-PL, M-AR, AA, DJ, NB, VD, CB, ML, CC and EM have no conflicts of interest that are directly relevant to the content of this study.

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Say, M., Boralévi, F., Lenormand, C. et al. Clinical and Therapeutic Aspects of Linear Psoriasis: A Study of 30 Cases. Am J Clin Dermatol 19, 609–615 (2018). https://doi.org/10.1007/s40257-018-0354-9

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  • DOI: https://doi.org/10.1007/s40257-018-0354-9

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