The spectrum of histomorphological features in psoriasis: a three years study
Abstract
Introduction: Psoriasis is a common relapsing chronic inflammatory dermatological disease associated with significant morbidity. Psoriasis is the prototype of a group of cutaneous disorders (psoriasiform dermatitides). Although histopathology is considered ‘gold standard’ for the diagnosis of psoriasis, at times even histopathological findings are confusing and inconclusive.
Aim of the study: To study the histopathological findings at different stages of psoriasis and its subtypes.
Materials and Methods: A total of 101 cases were studied for histopathological features. Results: Most of the cases were noted in the age group of 31 to 40 years (25.9%). There was a male predominance with male to female ratio of 2.7:1. Psoriasis vulgaris was the most common clinical type followed by Palmoplantar psoriasisand Erythrodermic psoriasis. Parakeratosis was the only consistent feature followed by ddilated blood vessels/abnormal capillary pattern and elongation of rete ridges with thickening at lower ends. The other frequent features were acanthosis and agranulosis / hypogranulosis.
Conclusion: Histopathology of psoriatic plaques exhibits heterogeneity and microscopic features will vary according to the stage of the disease. Though most of the predominant morphologic features of psoriasis are related to the epidermis, the presence of dilated blood vessels and/or abnormal capillary pattern is a constant finding in all stages of psoriasis and thus, can help in diagnosis of psoriatic lesion when in doubt.
Downloads
References
2. Dogra S, Yadav S. Psoriasis in India: prevalence and pattern. Indian J Dermatol VenereolLeprol. 2010 Nov-Dec;76(6):595-601. doi: 10.4103/0378-6323.72443.[pubmed]
3. Mehta S, Singal A, Singh N, et al. A study of clinic histopathological correlation in patients of psoriasis and psoriasiform dermatitis. Indian J Dermatol VenereolLeprol. 2009 Jan-Feb;75(1):100.[pubmed]
4. Khalil FK, Keehn CA, Saeed S, et al. Verrucous psoriasis: a distinctive clinicopathologic variant of psoriasis. Am J Dermatopathol. 2005 Jun;27(3):204-7.[pubmed]
5. Linden KG, Weinstein GD. Psoriasis: current perspectives with an emphasis on treatment. Am J Med. 1999 Dec;107(6):595-605.[pubmed]
6. Kaur I, Handa S, Kumar B. Natural history of psoriasis: a study from the Indian subcontinent. J Dermatol. 1997 Apr;24(4):230-4.[pubmed]
7. Sehgal VN, Dogra S, Srivastava G, et al. Psoriasiform dermatoses. Indian J Dermatol VenereolLeprol. 2008 Mar-Apr;74(2):94-9.[pubmed]
8. Murphy M, Kerr P, Grant-Kels JM. The histopathologic spectrum of psoriasis. Clin Dermatol. 2007 Nov-Dec;25(6):524-8.DOI:10.1016/j.clindermatol.2007.08.005.[pubmed]
9. Trozak DJ. Histologic grading system for psoriasis vulgaris. Int J Dermatol. 1994 May;33(5):380-1.[pubmed]
10. Micali G, Lacarrubba F, Musumeci ML, et al. Cutaneous vascular patterns in psoriasis. Int J Dermatol. 2010 Mar;49(3):249-56. doi: 10.1111/j.1365-4632.2009.04287.x.[pubmed]
11. Cribier BJ. Psoriasis under the microscope. JEADV 2006;20(Suppl 2):3-9.
12. Asokan N, Prathap P, Ajithkumar K, et al. Pattern of psoriasis in a tertiary care teaching hospital in South India. Indian J Dermatol. 2011 Jan;56(1):118-9. doi: 10.4103/0019-5154.77575.[pubmed]
13. Golpour M, Hosseini SH, Khademloo M, et al. Depression and Anxiety Disorders among Patients with Psoriasis: A Hospital-Based Case-Control Study. Dermatol Res Pract. 2012;2012:381905. doi: 10.1155/2012/381905. Epub 2012 Jul 16.[pubmed]
14. Raghuveer C, Shivanand DR, Rajashekar N. Clinico-histopathological Study of Psoriasis. Int J Sci Stud 2015;3(7):176-179.
15. Bai S, Sowmya S. Histopathologic diagnostic parameters of psoriasis; a clinicopathological study. Int J Res Med Sci 2016;4:1915-20.
16. Thomas J, Kumar NA, Manoharan D, Cynthia S, Prabu SKS, Ahmed NA. A study of comorbid conditions in psoriasis. Journal of Pakistan Association of Dermatologists 2009;19:200-2.
17. Puri N, Mahajan BB, Kaur S. Clinicohistopathological Correlation of Psoriasis in Acute Exacerbation.2012;1:455. doi:10.4172/scientificreports.455.
18. De Rosa G, Mignogna C. The histopathology of psoriasis. Reumatismo. 2007;59 Suppl 1:46-8.[pubmed]
19. Chanadanwale SS, Panicker NK, Kulkarni SP, Shah KR, Kumar H, Sharma YK, et al. Morphometry analysis of psoriasis and psoriasiform dermatitis: A retrospective study of 50 cases. Med J DY Patil Univ2015;8:43-7.
20. Park JH, Park YJ, Kim SK, et al. Histopathological Differential Diagnosis of Psoriasis and Seborrheic Dermatitis of the Scalp. Ann Dermatol. 2016 Aug;28(4):427-32. doi: 10.5021/ad.2016.28.4.427. Epub 2016 Jul 26.
21. Abdu NN, Bugude G, Mallikarjun M, Deepadarshan K. Clinical and histopathological study of psoriasis. Med Pulse International Journal of Medicine 2017;4(2):58-63.
22. Kim BY, Choi JW, Kim BR, et al. Histopathological findings are associated with the clinical types of psoriasis but not with the corresponding lesional psoriasis severity index. Ann Dermatol. 2015 Feb;27(1):26-31. doi: 10.5021/ad.2015.27.1.26. Epub 2015 Feb 3.
23. GhasemiBasir HR, Alirezaei P, Hamian Z, et al. Are quantitative histopathologic criteria capable of differentiating psoriasis from chronic dermatitis? Clin CosmetInvestig Dermatol. 2018 May 10;11:239-244. doi: 10.2147/CCID.S160697. eCollection 2018.[pubmed]
24. Barr RJ, Young EM Jr. Psoriasiform and related papulosquamous disorders. J CutanPathol. 1985 Oct;12(5):412-25.[pubmed]
26. Chowaniec O, Jabłońska S, Beutner EH, et al. Earliest clinical and histological changes in psoriasis. Dermatologica. 1981;163(1):42-51.[pubmed]
26. Toussaint S, kamino H. Non- infectious erythematous papular and squamous diseases of the skin. In: Elder D, Elenitsas R, Jaworsky C, Johnson B, editors. Lever's Histopathology of the skin. 8th edition ed. Philadelphia: Lippincott-Raven; 1997. p. 156-63.
27. Griffin TD, Lattanand A, VanScott EJ. Clinical and histologic heterogeneity of psoriatic plaques. Therapeutic relevance. Arch Dermatol. 1988 Feb;124(2):216-20.[pubmed]
OAI - Open Archives Initiative
