Hard as a rock: a case of massive rupioid psoriasis

Psoriasis is a common dermatosis characterized by several clinical features. It can also show unusual clinical presentations, including inverse, photosensitive, elephantine, and rupioid psoriasis. In the literature it has been described only few cases of rupioid psoriasis, also known as ostraceous psoriasis. This rare variant of psoriasis is characterized by hard, well-defined, cone-shaped lesions. Most cases of rupioid psoriasis were associated with arthropathy. Here we reported a case of extensive rupioid psoriasis in a 50 years old homeless without arthropathy. Although psoriasis is a common and well-described disease, it could show atypical and uncommon presentation, that could represent a pitfall for clinicians. For this reason, it is of capital importance to know how proteiform psoriasis could be, in order to evaluate properly the patients and better treat them.