Elephantine psoriasis with papillomatosis and alternating hypogranulosis and hypergranulosis (original) (raw)
Related papers
Medical Clinical Update
Background Psoriasis is a chronic inflammatory skin disease with a strong genetic predisposition and autoimmune pathogenic traits. Psoriasis vulgaris is also called plaque-type psoriasis, and is the most prevalent type. Psoriasis vulgaris is chronic inflammatory disease and characterized by periods of attack and remission. The chronicity of psoriasis vulgaris can affect patient’s quality of life. Case presentation A 33-year-old male came to Unggul Karsa Medika Hospital’s outpatient department with itchy, scaly, red plaques all over his body except his palms, soles, and face. The patient went to the dermatologist because his symptoms were getting worse and worse. Dermatologic examination concludes the lesions as multiple, generalized, discrete, circumscriptive, elevated, dry, regular-discoid erythematous plaques with psoriasiform scales located at the patient’s head, ears, nape, back, chest, belly, both arms and legs. Conclusion The diagnosis of psoriasis vulgaris was made based on h...
Histopathologic diagnostic parameters of psoriasis; a clinicopathological study
International Journal of Research in Medical Sciences, 2016
This disease is characterized by chronic, recurrent exacerbations and remissions that are emotionally and physically debilitating. Long term of psoriasis may cause psoriatic arthritis and risk for co-morbidities. 4 The cardinal histopathological features of psoriasis are a combination of the following: acanthosis, mounds of parakeratosis in an orthokeratotic cornified layer, supra papillary thinning, papillomatosis, inter cellular edema, scattered mitosis of basal and prickle cells and ABSTRACT Background: Psoriasis is a common inflammatory skin disorder comprised of varied histo-morphological features involving both epidermis and dermis. Further, there are psoriasiform lesions which simulate psoriasis. Hence it is mandatory to recognise psoriasis based on histopathological parameters to aid the treatment protocol. Methods: Sixty cases of histopathologically confirmed psoriasis vulgaris and pustular psoriasis excluding psoriasiform dermatitis, reported in the Department of Pathology, over a period of 6 years were analysed. The sections were stained with hematoxylin and eosin stains and analyzed for various morphological parameters. Results: Out of 60 cases 88.33% were psoriasis vulgaris and 11.67% were pustular psoriasis. Age incidence was high in second and fourth decades with male predominance. The commonly involved sites were upper and lower extremities. Significant histopathological parameters were parakeratosis (100%), hyperkeratosis (100%), spongiosis (91.67%), and papillomatosis (73.33%), either hypogranulosis (55%) or agranulosis (45%), and dilated and tortuous capillaries (88.33%, 43.33% respectively) in the dermis. Conclusions: Histopathological correlation is still the gold standard tool for the diagnosis of psoriasis. In the absence of well-formed Munro microabscess and pustules of Kogoj, other epidermal features like parakeratosis, hyperkeratosis, spongiosis, papillomatosis and absent or thinned out granular layer as well as dilated and tortuous capillaries in the dermis can be considered as confirmatory evidence of psoriasis. The reduction or complete absence of granular layer was characteristic of psoriasis and reflected the pathogenesis of defective keratinocyte proliferation.
An unusual cause for a psoriasiform dermatosis
Clinical and Experimental Dermatology, 2016
A 79-year-old woman presented with a 5-month history of a painful dermatosis affecting her hands and feet. This developed into inflammation with fissuring, affecting the fingers and toes. The patient was a current smoker with a 65-pack-year history. She had no other medical conditions, no respiratory symptoms and was otherwise systemically well.
Linear Psoriasis: A Case Report of a 71-Year-Old Female
Skin, 2018
A 71-year-old woman presented to the clinic with a one-month history of pruritic, burning, flaky pink to dark red erythematous plaques. The lesions had a very narrow, linear, Blashkoid distribution which extended from the left lateral sole to the popliteal region (Figure 1). The right leg also had a similar erythematous plaque located at the pretibial region. The patient had no other lesions or previous history of psoriasis. Punch biopsies were performed which revealed orthokeratosis and mounds of parakeratosis, and traumatized Koebnerization. Elongation of rete ridges was not prominent, however, mild psoriasiform hyperplasia and suprapapillary thinning of the epidermis with Funding: none.
Saudi Journal of Pathology and Microbiology, 2020
Background and Objectives: Psoriasis is a chronic papulosquamous disorder with constant exacerbations and remissions. Based on the clinical overlap with other papulosquamous disorders and the role of histopathology in diagnosis, we undertook a study on psoriasis. The objective of this study was to identify combination of histopathological parameters for the diagnosis of psoriasis and establish their reliability and significance. Material and Methods: A retrospective cum prospective study over a period of 5 years was carried out. 56 clinically diagnosed cases of psoriasis were taken into consideration. Skin biopsies were taken from these cases and histopathological examination was done. These lesions were then assessed based on various histopathological parameters. Results and Discussion: Maximum number of cases were in the age group of 31-40 years, males being three times more affected than females. The most common symptom was pruritis and psoriasis vulgaris was the most common variant. Upper limbs and back were most frequently affected. Among the microscopic parameters, acanthosis and parakeratosis were observed and when present with features like hypogranulosis, elongation of rete ridges, dermal inflammation and vasodilation or perivascular lymphocytic infiltrate were likely to indicate psoriasis. Munro micro abscesses and spongiform pustules of Kogoj, diagnostic features of psoriasis were also seen in significant proportion. Conclusion: Diagnosis of psoriasis is made based on the analysis of clinical symptoms and signs with a correlation with histopathological features. The relative ambiguity associated with this disease makes such histopathologic studies all the more important.
A Clinico-Pathological Study of Psoriasis and Psoriasiform Dermatitis
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Psoriasis is a chronic skin condition, which can have varied presentation either per se or because of various treatment modalities, which can closely simulate any different dermatological conditions. Hence, a clinicohistopathological correlation is necessary for confirmation of diagnosis and treatment. Very few studies are available in the indexed journals on this subject matter. The present study is aimed to study the clinical and histological features of psoriasiform dermatitis and psoriasis. METHODS This was a longitudinal study consisting of 60 subjects divided into two classes based on clinical diagnosis. Class A patients with diagnosed psoriasis and class B subjects with psoriasiform dermatitis. Many patients have had specific examination and skin biopsy. RESULTS Majority of the cases (40 %) were in the age group of 31 - 40 years. Most common clinical diagnosis was psoriasis (56.7 %) followed by allergic contact dermatitis (13.3 %), pityriasis rosea (8.3 %), lichen ...