PUVA cream phototherapy and topical corticoster- oids result in dramatic improvement of the disease with significant psychosocial benefit. DETERMINATION OF EGFR, BCL-2 AND KI 67 IN PATIENTS WITH ORAL LICHEN PLANUS

pustules were present concurrently. The patient complained of occasional pruritus and burning. Chronic plaque psoriasis on elbows was confirmed seven years before, for which she received topical corticosteroids. Focal infections were not found on clinical examination. It is important to note that the patient’s smoking habit aggravated the condition. Palmoplantar pustular psoriasis was diagnosed based on clinical picture and histopathologic appearance. Histopathologic analysis of skin lesion of the sole showed epidermal acanthosis with parakeratosis and large accumulation of neutrophils within the stratum spinosum, known as spongiform pustule of Kogoj. In the dermis, the capillaries were elongated and tortuous. PUVA cream phototherapy was administered five times weekly for four weeks of her hospital stay. Topical corticosteroids were applied under hydrocolloid occlusion, which significantly enhanced regression of the skin lesions. Most patients with palmoplantar pustular psoriasis have an underlying disease that can be identified, but in our case the onset, fluctuations and duration of the disease were not associated with focal infections. It is important to note that smoking aggravates the disease and has unfavorable impact on treatment success. PUVA cream phototherapy and topical corticosteroids result in dramatic improvement of the disease with significant psychosocial benefit.