'Coral reef' psoriasis: a marker of resistance to topical treatment.

ABSTRACT

Psoriasis plaques that have very thick adherent scale (so-called coral reef or rupioid psoriasis) tend to be resistant to topical treatment. We present a case of coral reef psoriasis that responded to topical clobetasol 0.05% spray without concomitant use of moisturizers or keratolytic agents. We propose that coral reef psoriasis is resistant to topical corticosteroids because of poor adherence to treatment, not because of poor penetration of applied agents.