case_images: PMC11430214_01
case_images: Rash on the left side of the abdomen, trunk, and lower extremities of a patient with psoriasis at the site of herpes zoster and a pseudohernia of the abdominal wall. (A) The left side of the abdomen is elevated compared to the right side. (B) The left side of the waist and abdomen displays a banded distribution of brownish-brown patches and plaques, accompanied by dense red papules and plaques covered with a large number of silvery-white scales. (C and D) The lower limbs and buttocks emanate red plaques covered with a large number of silvery-white scales.
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case_images: During a general physical examination, the patient exhibited a visible left abdominal bulge while standing (Figure 1A). The area displayed dense red papules and plaques, as displayed in Figure 1A and B. Auspitz sign was positive. Additionally, red plaques and scales were scattered over the trunk and lower limbs, as displayed in Figure 1B-D.
case_images: Computed tomography of the abdomen displays a flaccid thinning of the left abdominal wall, with no evidence of an intra-abdominal space, an effusion, or an abdominal wall hernia.
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case_images: No abnormalities were detected in computed tomography scans of the entire abdomen of the remaining patient (Figure 2).
case_images: Pathological image of the left lumbar lesion with psoriasis and abdominal wall pseudo-incision at the site of herpes zoster. Continuous parakeratosis and Munro microabscesses, regular epidermal hyperplasia, thinning of the stratum spinosum above the papillae, dilated and congested superficial dermal capillaries, and focal inflammatory cell infiltration of superficial blood vessels with predominantly lymphocytes are observed (hematoxylin and eosin staining, x100).
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case_images: Additionally, foci of inflammatory cell infiltration, predominantly lymphocytes, were observed around the superficial blood vessels (Figure 3).  