How is small plaque parapsoriasis (SPP) treated?

Updated: Sep 04, 2019
  • Author: Henry K Wong, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Small plaque parapsoriasis usually is asymptomatic. Treatment should be based on alleviation of symptoms associated with scaliness, and patients should be reassured of the benign self-limiting nature of the disease.

Emollients may be sufficient to treat scaliness; however, a trial of midpotency topical steroids (class 3-5) may lead to greater clinical responsiveness.

Phototherapy is effective in treating lesions that are widely scattered. Broad- or narrow-band UV-B can be effective and can lead to remission. [16, 17] More recalcitrant presentations can be treated with psoralen and long-wave ultraviolet radiation (PUVA).

Annual follow-up is recommended. An increase in the number of lesions, an increase in the size of lesions, or the development of induration or epidermal atrophy should prompt a repeat skin biopsy to consider a diagnosis of mycosis fungoides (MF) in evolution.


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