Clinical and histopathological study of psoriasis

 

Noshin N Abdu¹, Gangadhar Bugude^2*, Mallikarjun M³, Deepadarshan K⁴

 

Abstract              Background: Psoriasis is a common, genetically determined, inflammatory and proliferative disease of the skin, the most characteristic lesions consisting of chronic, sharply demarcated, dull red, scaly plaques, particularly on the extensor prominences and in the scalp. The disease is enormously variable in duration and extent and morphological variants are common Objectives: 1.To Study various clinical presentations of psoriasis. 2.To Study the histopathological features in various forms of psoriasis to differentiate other papulosquamous disorders Methods: A random of 50 patients who attended the outpatient Department of Dermatology and Venereology K.V.G Medical College and Hospital, Sullia, during a period extending from Jan 2012 to June 2013 and clinically diagnosed as psoriasis were selected consecutively for study. Name, age, sex, occupation and full address were recorded. The presenting complaints and their duration was noted with detailed history with reference to ge of onset, site of onset, past treatment, seasonal variation, triggering factors, family history of the disease, other systemic diseases, habits and development of lesions at the site of trauma. Patients not willing for biopsy, patients with systemic illness and pregnant women were excluded from the study. A complete general physical examination was done and the findings were recorded. Skin examination was done in detail with special reference to the morphology and the sites of involvement. A fresh lesion was scraped with a clean glass slide to find out the type of scaling and to look for Auspitz sign. Nails, mucous membranoes and scalp were examined. In addition, thorough systemic examination was done in all patients. Results: In our study, chronic plaque psoriasis (84%) was the commonest clinical type seen followed by guttate(8%), palmoplantar psoriasis(2%), erythrodermic (2%),generalised pustular psoriasis(4%) and psoriatic arthropathy(1%).one patient with erythrodermic psoriasis and one patient with chronic plaque psoriasis had concomitant arthritis. Majority of patients(23%) were in the age group of 21-40yrs.Male to female ratio was 2.84:1.Majority of the patients(32%) were agriculturists. Conclusion: The study concludes that psoriasis is commonly seen in the third and fourth decade and more number of males were affected than females. on set being earlier in females than males. More number of patients affected were agriculturists, who are more prone for trauma and agriculturists constitute a predominant group in this area. Because the clinical presentation is varied, the definitive diagnosis may depend on histological examination However, the histological changes of psoriasis are as varied as the clinical presentations. So, combination of clinical and histopathological features must be present for diagnosis of psoriasis to be made.

Key Word: chronic plaque psoriasis, erythrodermic psoriasis, Micromunro abscesses, Spongyform pustules of Kogoj