How is large plaque parapsoriasis (LPP) treated?

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

Large plaque parapsoriasis should be treated, because treatment may prevent progression to MF (cutaneous T-cell lymphoma [CTCL]). Therapy includes mid- to high-potency topical steroids (class 2-4), topical nitrogen mustard, and topical carmustine (BCNU). Patients using topical treatment need follow-up every 2-3 months. [18]

Phototherapy with either broad- or narrow-band UV-B or PUVA can be effective in inducing remission. Phototherapy requires an evaluation to response after every 8-12 visits or monthly.

Large plaque parapsoriasis requires closer follow-up than small plaque parapsoriasis. Follow-up frequency is determined by the treatment modality used. Follow-up every 6 months is recommended. Increasing number of lesions, increase in lesion size, or the development of induration or epidermal atrophy should prompt a repeat skin biopsy to consider a diagnosis of MF in evolution. If patients remit or do not desire treatment, follow-up is still recommended to assess for recurrence or progression.


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