A Clinico-Pathological Study of Psoriasis and Psoriasiform Dermatitis

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 simplex chronicus (5 %), seborrheic dermatitis (3 %), Devergie’s disease (3 %), and pityriasis lichenoides chronica (1.6 %). Clinicopathological concordance with psoriasis was seen in 68 cases (68 %) and discordance in 32 cases (32 %). CONCLUSIONS Clinically psoriasis vulgaris can be diagnosed (> 80 %) by presence of micaceous scales, along with grattage test and Auspitz’s sign. But in few, morphological variants of psoriasis and psoriasis modified due to various treatment modalities, we may not see the classical presentation and may mimic various other conditions (psoriasiform dermatitis), in which case a histopathological conformation is essential for diagnosis and treatment. KEYWORDS Psoriasis, Psoriasiform Dermatitis, Auspitz’s Sign, Histopathology