Psoriasis with balanopreputial lesions in a 9-year-old boy.

Abstract

A 9-year-old boy was first observed for the presence of nail changes of all the fingers. Psoriasis was reported in his father and paternal uncle. The physical examination showed an irregular surface due to the presence of longitudinal grooves and ridges in all the nails of hands. We diagnosed trachyonichia in a subject with positive family history for psoriasis and prescribed 1% tazarotene on the nail matrix and 50% urea on the nail plate. We saw again the child after a few months due to the presence of frankly psoriatic lesions of the scalp. When aged 12 the child had persistent balanoposthitis for some months, asymptomatic, with clear-cut limits without scaling at the level of the glans (Fig. 3). The scalp and nail changes, which had not been affected significantly by topical therapy, persisted unhanged (Fig. 1, 2). The final diagnosis was psoriasis with balanopreputial and nail involvement.