Proportion of psoriasis among the patients with psoriasiform disorders
Keywords:Psoriasis, Dermatitis, Keratosis, Hyperkeratosis, Hyperplasia
Background: Psoriasis is a prevalent chronic inflammatory skin disease with several clinical symptoms. Psoriasis has clinical forms that resemble a variety of dermatological disorders and may necessitate histological confirmation of the diagnosis. The aim of the study was to assess the proportion of psoriasis among patients with psoriasiform disorders.
Methods: This cross-sectional observational study was carried out at the department of dermatology and venereology, Shahid Syed Nazrul Islam Medical College, Kishoreganj during the period from January 2021 to December 2021 on 200 patients with psoriasiform disorders was enrolled in this study. Detailed history along with relevant family history and drug history was obtained. All the patients underwent skin biopsy followed by a histopathological examination to reveal the actual pathology of dermal lesions. Statistical analyses of the results were obtained by using window-based computer software devised with statistical packages for social sciences (SPSS-25).
Results: The proportion of psoriasis among the patients with psoriasiform disorders was found at 53.5%. The majority of patients (72.0%) had extensor surfaces and a well-demarcated border was found in 166 (83.0%) patients. Subungual hyperkeratosis was found in 30 (28.0%) and 16 (17.3%) in psoriasis and non-psoriasis groups respectively. Regular epidermal hyperplasia was 2 (1.9%) in psoriasis but not found in non-psoriasis. Spongiosis was 45 (42.1%) in psoriasis and 30 (32.3%) in non-psoriasis. The vertical orientation of the collagen bundle was 2 (1.9%) and 2 (2.2%) in psoriasis and non-psoriasis respectively. Perivascular lymphocyte infiltration was 75 (70.1%) in psoriasis and 63 (67.7%) in non-psoriasis. The difference was not statistically significant (p>0.05) between the two groups.
Conclusions: All clinical features were significantly associated with psoriasis in patients who presented with psoriasiform disorders except subungual hyperkeratosis. In histopathology, all features were significantly associated with psoriasis excluding regular epidermal hyperplasia, spongiosis, vertical orientation of collagen bundle, and perivascular lymphocyte infiltration.
Tirumalae R. Psoriasiform dermatoses: microscopic approach. Indian J Dermatol. 2013;58(4):290-3.
Ackerman AB, Boer A, Bennin B, Gottlieb G. Histologic diagnosis of inflammatory skin disease: An algorithmic method based on pattern analysis. 3rd edition. New York: Ardor Scribendi. 2005.
Sarac G, Koca TT, Baglan T. A brief summary of clinical types of psoriasis. North Clin Istanb. 2016;3(1):79-82.
Burden AD, Kirby B. Psoriasis and related disorders. In Griffiths CEM, Barker J, Bleiker T, Chalmers R, Creamer D, editiors. Rook’s Text-book of Dermatology, edition 9. Oxford, John Wi-ley & Sons, Ltd. 2016.
Murphy M, Kerr P, Grant-Kels JM. The histopathologic spectrum of psoriasis. Clin Dermatol. 2007;25(6):524-8.
Meglio PD, Villanova F, Nestle FO. Psoriasis Cold Spring Harb Perspect Med. 2014;4(8):a015354.
Mehta S, Singal A, Singh N, Bhattacharya S. A study of clinicohistopathological correlation in patients of psoriasis and psoriasiform dermatitis. Indian J Dermatol Venereol Leprol. 2009;75(1):100.
Kowalewska B, Cybulski M, Jankowiak B, Krajewska-Kułak E. Acceptance of illness, satisfaction with life, sense of stigmatization, and quality of life among people with psoriasis: a cross-sectional study. Dermatol Ther (Heidelb). 2020;10(3):413-30.
Hart PH, Gorman S, Finlay-Jones JJ. Modulation of the immune system by UV radiation: more than just the effects of vitamin D?. Nat Rev Immunol. 2011;11(9):584-96.
Parisi R, Symmons DP, Griffiths CE, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Investig Dermatol. 2013;133(2):377-85.
Tollefson MM, Crowson CS, McEvoy MT, Kremers HM. Incidence of psoriasis in children: a population-based study. J Am Acad Dermatol. 2010;62(6):979-87.
Bhuiyan MS, Sikder MS, Mahmud M, Nandy AK, Haque MM. Prevalence of psoriasis in Bangladesh: A community based survey. J Pak Assoc Dermatol. 2020;30(1):39-45.
Langley RG, Krueger GG, Griffiths C. Psoriasis: epidemiology, clinical features, and quality of life. Annals of the rheumatic diseases. 2005;64(2):18-23.
Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. The Lancet. 2007;370(9583):263-71.
Samarasekera EJ, Neilson JM, Warren RB, Parnham J, Smith CH. Incidence of cardiovascular disease in individuals with psoriasis: a systematic review and meta-analysis. J Investig Dermatol. 2013;133(10):2340-6.
Jayalakshmy PL, Babitha AM, Sankar S, Nandakumar G. Histopathological spectrum of Psoriasiform dermatitis. J Pathol Nepal. 2016;24:975-80.
Khandpur S, Singhal V, Sharma VK. Palmoplantar involvement in psoriasis: A clinical study. Indian J Dermatol Venereol Leprol. 2011;77:625.
Chanadanwale SS, Panicker NK, Kulkarni SP, Shah KR, Kumar H, Sharma YK, Pal S. Morphometry analysis of psoriasis and psoriasiform dermatitis: A retrospective study of 50 cases. Med J Dr. DY Patil University. 2015;8(1):43-7.
Icen M, Crowson CS, McEvoy MT, Dann FJ, Gabriel SE, Kremers HM. Trends in incidence of adult-onset psoriasis over three decades: a population-based study. J Am Acad Dermatol. 2009;60(3):394-401.
Dogra S, Yadav S. Psoriasis in India: Prevalence and pattern. Indian J Dermatol Venereol Leprol. 2010;76:595-601.
Singh SK. Finger nail pitting in psoriasis and its relation with different variables. Indian J Dermatol. 2013;58(4):310.
Rahier JF, Buche S, Peyrin–Biroulet L, Bouhnik Y, Duclos B, Louis E, Papay P, Allez M, Cosnes J, Cortot A, Laharie D. Severe skin lesions cause patients with inflammatory bowel disease to discontinue anti–tumor necrosis factor therapy. Clin Gastroenterol Hepatol. 2010;8(12):1048-55.
Gyanchandani N, Kalaivani P, Shivashekar G, Ramraj B. Clinicomorphological correlation of psoriasis and psoriasiform dermatitis. Int J Clin Diagnostic Pathol. 2020;3(2):1-5.
Moorchung N, Vasudevan B, Chatterjee M, Mani NS, Grewal RS. Interleukin-1 gene polymorphisms and their relation with NFκB expression and histopathological features in psoriasis. Indian J Dermatol. 2015;60:432-8.
Gelfand JM, Stern RS, Nijsten T, Feldman SR, Thomas J, Kist J, Rolstad T, Margolis DJ. The prevalence of psoriasis in African Americans: results from a population-based study. J Am Acad Dermatol. 2005;52(1):23-6.
Puri N, Mahajan BB, Kaur S. Clinicohistopathological correlation of psoriasis in acute exacerbation. Open Access Sci Rep. 2012;1(9):455.
De Rosa G, Mignogna C. The histopathology of psoriasis. Reumatismo. 2007;591):46-8.
Toussaint S, Hideko K. 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. 8 th edition. Philadelphia: Lippincott-Raven. 1997;156-63.
Chopra A, Gill SS. Histopathological study of hyperkeratosis of palms and soles. Indian J Dermatol Venereol Leprol. 1997;63(2):82-4.