Original Research Article
Year: 2020 | Month: December | Volume: 10 | Issue: 12 | Pages: 8-16
Psoriasis - A Clinicopathological Correlation in a Tertiary Care Hospital
Reeta Dhar1, Jyotsna Sahai2, Priyanka Gaikwad3, Shilpi Sahu4
1,4Professors, 2,3Residents, Dept of Pathology, MGM Medical College, Kamothe, Navi Mumbai
Corresponding Author: Jyotsna Sahai
ABSTRACT
Background - Psoriasis is a group of common chronic inflammatory and proliferative skin conditions associated with systemic manifestations in many organ systems. Its prevalence is poorly defined in India and its presentation varies with different stages and can simulate various other conditions also.
Materials and Methods - This retrospective study was conducted to study the clinical and histomorphological variants of psoriasis and incidence of age and sex distribution in various types of psoriasis in a tertiary care hospital. 9 parameters were used to assess and categorize the various types of psoriasis –
1) Hyperkeratosis
2) Parakeratosis
3) Munro’s microabscesses
4) Pustule of Kogoj
5) Supra – papillary thinning
6) Elongated rete ridges
7) Inflammatory infiltrate in the dermis
8) Capillary proliferation and dilatation
9) Spongiosis
Results – A male preponderance with maximum cases in the 31 – 40 years age group was found in our study. The predominant histological type was that of Psoriasis vulgaris (63%) followed by Chronic Plaque Psoriasis (18%). Amongst the cutaneous features of psoriasis, Scales were the most common (92%) followed by plaques (83%). The most commonly involved site was that of the upper extremities (79%). Amongst the epidermal histopathological features of psoriasis, acanthosis was seen in 100% cases followed by hyperkeratosis in 95% cases. The dermal features showed dermal infiltration in 97% cases.
Conclusion – Psoriasis has multiple relapses and remissions and also varied clinical presentations. Its diagnosis at the earliest is important to halt its progression and histomorphology helps in that. This study concluded that even though most changes occur in the epidermis in cases of psoriasis, there are a few dermal changes too which can aid the pathologist in arriving at the diagnosis. This study also helped in finding the prevalence of this disease in India, as there is paucity of the same in our country. Thus overall, this study helped in finding the various histomorphological features which are diagnostic of psoriasis as well as their incidence in various subtypes of psoriasis. It also adds to the data of the disease in our country and will help in better clinical management as well as triage of patients.
Key words: Dermatology, Histopathology, Plaques, Psoriasis, Scales, Vulgaris.