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Butterfly-shaped hypertrophic plaques on buttocks
Corresponding author: Dr. Shuaihantian Luo, Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China. lsht5309@csu.edu.cn
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Received: ,
Accepted: ,
How to cite this article: Long X, Zhang G, Luo S. Butterfly-shaped hypertrophic plaques on buttocks. Indian J Dermatol Venereol Leprol. doi: 10.25259/IJDVL_279_2025
A 53-year-old Chinese man presented with large, bilaterally symmetrical plaques on both buttocks, persisting for over ten years and associated with severe itching. He denied family history of similar condition. Physical examination revealed erythematous and symmetrical plaques with a verrucous surface distributed along the intergluteal cleft and buttocks. Adherent scales and multiple peripheral satellite papules were seen, exhibiting a butterfly-shaped appearance [Figure 1]. Histopathological examination revealed prominent epidermal irregular hyperplasia with hyperkeratosis, parakeratosis, and multiple discrete columns of parakeratosis, consistent with cornoid lamellae. Based on clinical and histopathologic features, porokeratosis ptychotropica was diagnosed. Ptychotropica is a term that originates from the Greek word for roots (“ptycho-” meaning fold and “tropica” implying adaptation or change). We considered differential diagnoses of inverse psoriasis, tuberculosis verrucosa cutis, epidermal naevus, and lichen planus. Patient was prescribed oral acitretin (30 mg/d) and topical retinoid cream with partial resolution of lesions and no aggravation at 1-year follow-up.
- Reddish-brown, hypertrophic, bilateral, and symmetrical verrucous plaques over buttocks with surrounding satellite lesions and exhibiting a unique butterfly-shaped appearance.
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Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
